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NPI Code Detail

MEDICARE: EDGE-MD HAMPTON, PLLC

MEDICARE: EDGE-MD HAMPTON, PLLC
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
1207Q00000XFamily Medicine PhysicianN0318TX

General Provider Information

NPI Number : 1154722387
Entity Type Code : Organization
Provider Name (Legal Business Name) : EDGE-MD HAMPTON, PLLC
Provider Business Mailing Address
First Line : 2022 REGIONAL MEDICAL DR
Second Line : SUITE 1315
City : WHARTON
State : TX
Zip : 77488-7231
Country : US
Telephone Number : 979-532-2000
Fax Number : 979-532-2008
Provider Business Practice Location Address
First Line : 322 S HAMPTON RD
Second Line :
City : DALLAS
State : TX
Zip : 75208-5617
Country : US
Telephone Number : 214-943-1500
Fax Number : 214-943-1503
Authorized Official
Title or Position : OWNER/MD
Name : DR. NATHAN P. NGUYEN
Credential : MD
Telephone Number : 979-532-2000
Provider Enumeration Date : 09/08/2014
Last Update Date : 01/13/2015

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Directions to “EDGE-MD HAMPTON, PLLC ” Practice Location

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