MEDICARE: VAN VAN NGUYEN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	H5194	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	808204	OTHER	TX	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1023015203
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VAN VAN NGUYEN MD

Provider Business Mailing Address
First Line	:	17010 SUGAR PINE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77090-2213
Country	:	US
Telephone Number	:	281-537-1491
Fax Number	:	281-893-7090

Provider Business Practice Location Address
First Line	:	17010 SUGAR PINE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77090-2213
Country	:	US
Telephone Number	:	281-537-1491
Fax Number	:	281-893-7090

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	02/22/2013

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Directions to “ VAN VAN NGUYEN MD” Practice Location

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