Healthcare Provider Details

I. General information

NPI: 1023123783
Provider Name (Legal Business Name): GIANG T. NGUYEN, MD, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 08/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2218 N HOBART ST
PAMPA TX
79065-3418
US

IV. Provider business mailing address

PO BOX 222
PAMPA TX
79066-0222
US

V. Phone/Fax

Practice location:
  • Phone: 806-665-2525
  • Fax:
Mailing address:
  • Phone: 806-665-2525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberL4194
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberL4194
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberL4194
License Number StateTX

VIII. Authorized Official

Name: DR. GIANG TUONG NGUYEN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 806-665-2525