MEDICARE: DONALD NGUYEN PT

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	225100000X	Physical Therapist	1174541	TX

General Provider Information

NPI Number	:	1558552208
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONALD NGUYEN PT

Provider Business Mailing Address
First Line	:	PO BOX 890389
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77289-0389
Country	:	US
Telephone Number	:	281-286-8520
Fax Number	:	281-286-2947

Provider Business Practice Location Address
First Line	:	1007 S CONGRESS AVE
Second Line	:	SUITE B11
City	:	AUSTIN
State	:	TX
Zip	:	78704-8707
Country	:	US
Telephone Number	:	512-326-5333
Fax Number	:	512-326-5335

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

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

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