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General NPI Number Information
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NPI Number | 1992903348
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Entity Type | Organization
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Legal Business Name | LONG.P.NGUYEN M.D., P.A.
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Dates
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Enumeration Date | 07/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4151 SOUTHWEST FWY 410
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City | HOUSTON
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State | TX
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Zip | 77027-7312
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Country | US
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Telephone | 713-222-7246
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Fax | 713-963-9993
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Provider Business Mailing Address
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Address Line | PO BOX 460368
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City | HOUSTON
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State | TX
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Zip | 77056-8368
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Country | US
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Telephone | 713-222-7246
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Fax | 713-963-9993
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LONG PHAN NGUYEN
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Credential | M.D
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Telephone | 713-222-7246
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | G7293
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License Number State | TX
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