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General NPI Number Information
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NPI Number | 1538748645
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Entity Type | Individual
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Provider Name | AI VAN VO NGUYEN
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Gender | Female
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Dates
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Enumeration Date | 04/06/2021
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Last Update Date | 04/06/2021
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Provider Practice Location Address
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Address Line | 209 CHASEMORE LN
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City | ARLINGTON
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State | TX
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Zip | 76018-1084
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Country | US
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Telephone | 682-225-7155
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Fax |
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Provider Business Mailing Address
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Address Line | 7107 ZUEFELDT DR
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City | ARLINGTON
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State | TX
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Zip | 76002-3813
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Country | US
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Telephone | 682-225-7155
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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 | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 226675
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License Number State | TX
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