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General NPI Number Information
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NPI Number | 1740009158
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Entity Type | Individual
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Provider Name | KATHLEEN THAM NGUYEN FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 10/03/2024
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Last Update Date | 10/03/2024
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Provider Practice Location Address
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Address Line | 1915 E MAYFIELD RD STE 115
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City | ARLINGTON
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State | TX
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Zip | 76014-2605
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Country | US
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Telephone | 682-276-6700
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Fax |
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Provider Business Mailing Address
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Address Line | 13840 BIRCHLAWN DR
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City | DALLAS
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State | TX
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Zip | 75234-3514
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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 |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2024003800
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 896649
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License Number State | TX
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