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General NPI Number Information
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NPI Number | 1245266949
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Entity Type | Individual
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Provider Name | NGUYEN PHAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/24/2006
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Last Update Date | 05/21/2012
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Provider Practice Location Address
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Address Line | 8515 SPRING CYPRESS RD SUITE 108
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City | SPRING
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State | TX
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Zip | 77379-3354
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Country | US
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Telephone | 281-376-2200
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Fax | 281-376-2205
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Provider Business Mailing Address
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Address Line | 8515 SPRING CYPRESS RD SUITE #108
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City | SPRING
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State | TX
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Zip | 77379-3354
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Country | US
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Telephone | 281-376-2200
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Fax | 281-376-2205
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | L9848
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License Number State | TX
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