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General NPI Number Information
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NPI Number | 1760671440
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Entity Type | Organization
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Legal Business Name | HUYEN NGUYEN MD PA
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Dates
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Enumeration Date | 10/18/2007
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Last Update Date | 05/29/2012
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Provider Practice Location Address
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Address Line | 12501 JUDSON RD SUITE 202
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City | LIVE OAK
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State | TX
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Zip | 78233-4103
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Country | US
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Telephone | 210-599-4086
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Fax |
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Provider Business Mailing Address
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Address Line | 12501 JUDSON RD SUITE 202
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City | LIVE OAK
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State | TX
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Zip | 78233-4103
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Country | US
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Telephone | 210-599-4086
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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. HUYEN THI NGUYEN
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Credential | M.D.
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Telephone | 210-599-4086
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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 | J9241
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License Number State | TX
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