MEDICARE: DR. TODD THANG NGUYEN 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	207R00000X	Internal Medicine Physician	M0513	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00297129	OTHER		MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0067MT	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1548249030
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TODD THANG NGUYEN M.D.

Provider Business Mailing Address
First Line	:	1119 W RANDOL MILL RD STE 103
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76012-6509
Country	:	US
Telephone Number	:	817-860-2700
Fax Number	:	817-860-2704

Provider Business Practice Location Address
First Line	:	1119 W RANDOL MILL RD STE 103
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76012-6509
Country	:	US
Telephone Number	:	817-860-2700
Fax Number	:	817-860-2704

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

Provider Enumeration Date	:	01/12/2006
Last Update Date	:	08/31/2023

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