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General NPI Number Information
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NPI Number | 1700063039
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Entity Type | Organization
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Legal Business Name | ST. MICHAEL MEDICAL CLINIC
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Dates
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Enumeration Date | 01/29/2008
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Last Update Date | 01/29/2008
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Provider Practice Location Address
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Address Line | 13727 CEDAR POINT DR
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City | HOUSTON
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State | TX
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Zip | 77070-2706
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Country | US
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Telephone | 281-655-5100
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Fax | 281-655-1415
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Provider Business Mailing Address
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Address Line | 13727 CEDAR POINT DR
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City | HOUSTON
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State | TX
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Zip | 77070-2706
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Country | US
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Telephone | 281-655-5100
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Fax | 281-655-1415
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THUAN K. NGUYEN
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Credential | M.D.
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Telephone | 281-655-5100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | K0353
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License Number State | TX
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