MEDICARE: SHAUN SINH VAN NGUYEN D.C.

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	111N00000X	Chiropractor	8527	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8527	OTHER	TX	LICENSE-DC

General Provider Information

NPI Number	:	1336188879
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAUN SINH VAN NGUYEN D.C.

Provider Business Mailing Address
First Line	:	3815 REVEILLE ST.
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77067
Country	:	US
Telephone Number	:	713-649-2201
Fax Number	:	713-643-5521

Provider Business Practice Location Address
First Line	:	3815 REVEILLE ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77087-4503
Country	:	US
Telephone Number	:	713-649-2201
Fax Number	:	713-643-5521

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

Provider Enumeration Date	:	06/06/2006
Last Update Date	:	07/08/2007

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