Healthcare Provider Details

I. General information

NPI: 1881663193
Provider Name (Legal Business Name): TUAN H NGUYEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 02/24/2021
Certification Date: 02/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4045 E BELKNAP ST SUITE 12
HALTOM CITY TX
76111-6638
US

IV. Provider business mailing address

4045 E BELKNAP ST STE 12
HALTOM CITY TX
76111-6637
US

V. Phone/Fax

Practice location:
  • Phone: 817-759-2315
  • Fax: 817-759-2316
Mailing address:
  • Phone: 817-759-2315
  • Fax: 817-759-2316

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberK7191
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: