MEDICARE: MR. NGOC X 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	174400000X	Specialist	J 3173	TX

General Provider Information

NPI Number	:	1255449856
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. NGOC X NGUYEN M.D.

Provider Business Mailing Address
First Line	:	8533 GULF FWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77017-5055
Country	:	US
Telephone Number	:	713-669-9395
Fax Number	:	713-941-9800

Provider Business Practice Location Address
First Line	:	8533 GULF FWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77017-5055
Country	:	US
Telephone Number	:	713-669-9395
Fax Number	:	713-941-9800

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

Provider Enumeration Date	:	08/25/2006
Last Update Date	:	11/26/2012

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