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General NPI Number Information
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NPI Number | 1962614016
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Entity Type | Individual
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Provider Name | MICHAEL P NGUYEN MD
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Gender | Male
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 3330 MASONIC DR
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City | ALEXANDRIA
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State | LA
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Zip | 71301-3841
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Country | US
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Telephone | 318-448-6734
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Fax |
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Provider Business Mailing Address
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Address Line | 12554 RIATA VISTA CIR # 350
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City | AUSTIN
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State | TX
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Zip | 78727-6431
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Country | US
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Telephone | 713-461-3574
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Fax | 713-468-1247
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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 | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 349941
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | M6311
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 036173122
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | M6311
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 036173122
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License Number State | IL
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Taxonomy #6
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | D0101761
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License Number State | MD
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