Healthcare Provider Details

I. General information

NPI: 1457349839
Provider Name (Legal Business Name): GIANG TUONG NGUYEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2005
Last Update Date: 04/13/2022
Certification Date: 04/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2218 N HOBART ST
PAMPA TX
79065-3418
US

IV. Provider business mailing address

2218 N HOBART ST
PAMPA TX
79065-3418
US

V. Phone/Fax

Practice location:
  • Phone: 806-440-1262
  • Fax:
Mailing address:
  • Phone: 806-665-2525
  • Fax: 806-665-2297

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:
Title or Position:
Credential:
Phone: