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General NPI Number Information
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NPI Number | 1538350301
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Entity Type | Organization
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Legal Business Name | TRUNG D. NGUYEN MD PA
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Dates
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Enumeration Date | 08/07/2007
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Last Update Date | 05/14/2008
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Provider Practice Location Address
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Address Line | 900 W MAGNOLIA AVE STE 201
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City | FORT WORTH
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State | TX
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Zip | 76104-8517
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Country | US
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Telephone | 817-921-5997
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Fax | 817-921-5998
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Provider Business Mailing Address
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Address Line | 900 W MAGNOLIA AVE STE 201
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City | FORT WORTH
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State | TX
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Zip | 76104-8517
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Country | US
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Telephone | 817-921-5997
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Fax | 817-921-5998
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | TRUNG D NGUYEN
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Credential | ND
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Telephone | 817-921-5997
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | J4391
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License Number State | TX
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