MEDICARE: THUY KIM NGUYEN

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	J8697	TX

General Provider Information

NPI Number	:	1336499508
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THUY KIM NGUYEN

Provider Business Mailing Address
First Line	:	2225 COUNTRY ROAD. 90, SUITE 117
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-4891
Country	:	US
Telephone Number	:	281-997-8813
Fax Number	:	281-997-0683

Provider Business Practice Location Address
First Line	:	3221 FANNIN ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77004-2901
Country	:	US
Telephone Number	:	281-997-8813
Fax Number	:	281-997-0683

Authorized Official
Title or Position	:	M.D.
Name	:	DR. THUY KIM NGUYEN
Credential	:
Telephone Number	:	281-997-8813

Provider Enumeration Date	:	09/14/2012
Last Update Date	:	09/14/2012

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