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General NPI Number Information
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NPI Number | 1477874790
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Entity Type | Organization
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Legal Business Name | VINH NGUYEN, MD, PA
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Dates
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Enumeration Date | 06/22/2010
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Last Update Date | 10/12/2011
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Provider Practice Location Address
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Address Line | 420 E 6TH ST SUITE 200
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City | ODESSA
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State | TX
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Zip | 79761-4529
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Country | US
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Telephone | 432-582-8998
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Fax | 432-582-8997
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Provider Business Mailing Address
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Address Line | 6915 STONEHENGE RD
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City | ODESSA
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State | TX
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Zip | 79765-8924
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Country | US
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Telephone | 432-349-2891
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. VINH H NGUYEN
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Credential | M.D
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Telephone | 432-349-2891
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | L3770
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License Number State | TX
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