Healthcare Provider Details

I. General information

NPI: 1770939837
Provider Name (Legal Business Name): ANGELA NGUYEN D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2016
Last Update Date: 05/04/2022
Certification Date: 05/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 N COLLINS ST STE 200
ARLINGTON TX
76005-4551
US

IV. Provider business mailing address

4100 N COLLINS ST STE 200
ARLINGTON TX
76005-4551
US

V. Phone/Fax

Practice location:
  • Phone: 817-860-1309
  • Fax: 817-860-5380
Mailing address:
  • Phone: 817-860-1309
  • Fax: 817-860-5380

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberBP10056104
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: