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General NPI Number Information
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NPI Number | 1316801863
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Entity Type | Organization
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Legal Business Name | STAFFORD MEDICAL & MED SPA, PLLC
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Dates
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Enumeration Date | 12/10/2025
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 4807 SUGAR GROVE BLVD STE 201
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City | STAFFORD
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State | TX
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Zip | 77477-2653
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Country | US
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Telephone | 901-550-9635
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Fax |
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Provider Business Mailing Address
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Address Line | 4807 SUGAR GROVE BLVD STE 201
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City | STAFFORD
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State | TX
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Zip | 77477-2653
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | TUAN ANH NGOC NGUYEN
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Credential | MD
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Telephone | 901-438-5011
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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