MEDICARE: TRUONG CHINH QUOC 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	L5489	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	8J0481	OTHER	TX	MEDICARE ID, UTMB 2012

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

General Provider Information

NPI Number	:	1174595219
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRUONG CHINH QUOC NGUYEN MD

Provider Business Mailing Address
First Line	:	1716 MCDUFFIE ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77019-5727
Country	:	US
Telephone Number	:	713-494-2020
Fax Number	:

Provider Business Practice Location Address
First Line	:	2060 SPACE PARK DR STE 308
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77058-3675
Country	:	US
Telephone Number	:	281-333-2744
Fax Number	:	281-335-4529

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

Provider Enumeration Date	:	02/03/2006
Last Update Date	:	01/28/2014

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