Healthcare Provider Details

I. General information

NPI: 1902393366
Provider Name (Legal Business Name): BRIAN HIEU NGUYEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2018
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

559 E OVILLA RD
RED OAK TX
75154-3505
US

IV. Provider business mailing address

559 E OVILLA RD
RED OAK TX
75154-3505
US

V. Phone/Fax

Practice location:
  • Phone: 214-286-6565
  • Fax: 817-533-6015
Mailing address:
  • Phone: 214-286-6565
  • Fax: 817-533-6015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberT1164
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: