Healthcare Provider Details

I. General information

NPI: 1932230273
Provider Name (Legal Business Name): HUNG THE NGUYEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 12/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 WRIGHT ST
ARLINGTON TX
76012-4731
US

IV. Provider business mailing address

925 WRIGHT ST
ARLINGTON TX
76012-4731
US

V. Phone/Fax

Practice location:
  • Phone: 817-801-5704
  • Fax:
Mailing address:
  • Phone: 817-801-5704
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberM5854
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: