MEDICARE: NGUYEN-OGHALAI RHEUMATOLOGY, PA

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	207K00000X	Allergy & Immunology Physician		TX
2	207RR0500X	Rheumatology Physician		TX

General Provider Information

NPI Number	:	1295971893
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NGUYEN-OGHALAI RHEUMATOLOGY, PA

Provider Business Mailing Address
First Line	:	3015 TAYLORCREST DR
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-9166
Country	:	US
Telephone Number	:	713-202-8217
Fax Number	:

Provider Business Practice Location Address
First Line	:	12924 BELLAIRE BLVD
Second Line	:	SUITE 100
City	:	HOUSTON
State	:	TX
Zip	:	77072-5131
Country	:	US
Telephone Number	:	713-202-8217
Fax Number	:	713-457-4200

Authorized Official
Title or Position	:	PRESIDENT
Name	:	TRACY U NGUYEN-OGHALAI
Credential	:	MD
Telephone Number	:	713-202-8217

Provider Enumeration Date	:	01/02/2009
Last Update Date	:	01/02/2009

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