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General NPI Number Information
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NPI Number | 1295265593
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Entity Type | Individual
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Provider Name | ELIZABETH TIEN NGUYEN MD
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Gender | Female
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Dates
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Enumeration Date | 06/19/2017
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Last Update Date | 10/21/2025
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Provider Practice Location Address
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Address Line | 3121 UNIVERSITY DR E STE 100
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City | BRYAN
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State | TX
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Zip | 77802-3499
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Country | US
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Telephone | 799-776-0169
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Fax | 799-776-1342
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Provider Business Mailing Address
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Address Line | 8441 STATE HWY 47 STE 3115
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City | BRYAN
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State | TX
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Zip | 77807
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Country | US
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Telephone | 979-436-9703
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Fax |
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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 | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | T9197
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME144828
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | T9197
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License Number State | TX
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