MEDICARE: HUYNH HOA NGUYEN DDS 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	122300000X	Dentist	24610	TX

General Provider Information

NPI Number	:	1326592544
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUYNH HOA NGUYEN DDS PA

Provider Business Mailing Address
First Line	:	2445 FULTON ST # B
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77009-7837
Country	:	US
Telephone Number	:	713-225-2266
Fax Number	:	713-225-2275

Provider Business Practice Location Address
First Line	:	2445 FULTON ST # B
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77009-7837
Country	:	US
Telephone Number	:	713-225-2266
Fax Number	:	713-225-2275

Authorized Official
Title or Position	:	PRESIDENT
Name	:	HUYNH HOA NGUYEN
Credential	:	D.D.S
Telephone Number	:	469-446-3833

Provider Enumeration Date	:	08/04/2016
Last Update Date	:	08/04/2016

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