Healthcare Provider Details

I. General information

NPI: 1376737189
Provider Name (Legal Business Name): DONG V NGUYEN, DPM PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2007
Last Update Date: 09/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 WRIGHT ST
ARLINGTON TX
76012-4731
US

IV. Provider business mailing address

1321 E PIONEER PKWY
ARLINGTON TX
76010-5868
US

V. Phone/Fax

Practice location:
  • Phone: 817-801-5704
  • Fax: 817-801-5707
Mailing address:
  • Phone: 817-801-5704
  • Fax: 817-801-5707

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP1100X
TaxonomyPodiatric Clinic/Center
License Number261QP1100X
License Number StateTX

VIII. Authorized Official

Name: DR. DONG V NGUYEN
Title or Position: PRESIDENT
Credential: DPM
Phone: 817-801-5704