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NPI Code Detail

MEDICARE: THIEN TRI NGUYEN

MEDICARE:   THIEN TRI 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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1366380628
Entity Type Code : Individual
Provider Name (Legal Business Name) : THIEN TRI NGUYEN
Provider Business Mailing Address
First Line : 12303 DE PAUL DR
Second Line :
City : BRIDGETON
State : MO
Zip : 63044-2512
Country : US
Telephone Number : 314-344-6000
Fax Number :
Provider Business Practice Location Address
First Line : 12303 DE PAUL DR
Second Line :
City : BRIDGETON
State : MO
Zip : 63044-2512
Country : US
Telephone Number : 314-344-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2026
Last Update Date : 03/24/2026

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Directions to “ THIEN TRI NGUYEN ” Practice Location

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