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General NPI Number Information
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NPI Number | 1831665272
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Entity Type | Organization
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Legal Business Name | MD24 TX, PA
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Dates
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Enumeration Date | 10/23/2018
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Last Update Date | 10/29/2019
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Provider Practice Location Address
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Address Line | 675 TOWN SQUARE BLVD STE 200
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City | GARLAND
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State | TX
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Zip | 75040-2991
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Country | US
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Telephone | 623-374-7774
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Fax | 855-420-6361
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Provider Business Mailing Address
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Address Line | 14780 W MOUNTAIN VIEW BLVD STE 110
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City | SURPRISE
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State | AZ
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Zip | 85374-7280
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Country | US
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Telephone | 623-374-7774
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | LINH CAO NGUYEN
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Credential | MD
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Telephone | 623-374-7774
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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