MEDICARE: HIEN K. NGUYEN-NGO M.D.

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	H0684	TX

General Provider Information

NPI Number	:	1396713111
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HIEN K. NGUYEN-NGO M.D.

Provider Business Mailing Address
First Line	:	9 MEDICAL PKWY
Second Line	:	SUITE 305
City	:	DALLAS
State	:	TX
Zip	:	75234-7858
Country	:	US
Telephone Number	:	972-247-3937
Fax Number	:	972-620-9635

Provider Business Practice Location Address
First Line	:	9 MEDICAL PKWY
Second Line	:	SUITE 305
City	:	DALLAS
State	:	TX
Zip	:	75234-7858
Country	:	US
Telephone Number	:	972-247-3937
Fax Number	:	972-620-9635

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

Provider Enumeration Date	:	03/08/2006
Last Update Date	:	10/24/2011

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