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NPI Code Detail

MEDICARE: DR. LAN T NGUYEN D.D.S.

MEDICARE: DR. LAN T NGUYEN D.D.S.
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
1122300000XDentist17157TX

General Provider Information

NPI Number : 1104041250
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LAN T NGUYEN D.D.S.
Provider Business Mailing Address
First Line : 2105 WOODS CT
Second Line :
City : PEARLAND
State : TX
Zip : 77581-5198
Country : US
Telephone Number : 281-922-0330
Fax Number :
Provider Business Practice Location Address
First Line : 1205 CLEAR LAKE CITY BLVD
Second Line :
City : HOUSTON
State : TX
Zip : 77062-8105
Country : US
Telephone Number : 281-488-1477
Fax Number : 281-286-2149
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2007
Last Update Date : 07/08/2007

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