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1225051360

NPI Code Detail

MEDICARE: JACKLYN BICHTHUY TRAN NGUYEN M.D.

MEDICARE: JACKLYN BICHTHUY TRAN NGUYEN M.D.

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	207L00000X	Anesthesiology Physician	246814	NY
2	207L00000X	Anesthesiology Physician	N1482	TX
3	207L00000X	Anesthesiology Physician	516791	FL
4	207L00000X	Anesthesiology Physician	G80857	CA
5	207L00000X	Anesthesiology Physician	ME135966	FL

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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225051360
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACKLYN BICHTHUY TRAN NGUYEN M.D.

Provider Business Mailing Address
First Line	:	2411 FOUNTAIN VIEW DR
Second Line	:	STE. 200
City	:	HOUSTON
State	:	TX
Zip	:	77057-4817
Country	:	US
Telephone Number	:	713-620-4000
Fax Number	:

Provider Business Practice Location Address
First Line	:	5801 E TAFT RD
Second Line	:
City	:	SYRACUSE
State	:	NY
Zip	:	13212-3291
Country	:	US
Telephone Number	:	315-418-4140
Fax Number	:

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

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	12/19/2024

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Directions to “ JACKLYN BICHTHUY TRAN NGUYEN M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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