MEDICARE: DR. THIEU VINH 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	174400000X	Specialist	J2236	TX

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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	8F1230	OTHER	TX	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1609967165
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THIEU VINH NGUYEN M.D.

Provider Business Mailing Address
First Line	:	7500 BEECHNUT ST STE 291
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77074-4336
Country	:	US
Telephone Number	:	713-272-9022
Fax Number	:	713-272-8707

Provider Business Practice Location Address
First Line	:	7500 BEECHNUT ST STE 291
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77074-4336
Country	:	US
Telephone Number	:	713-272-9022
Fax Number	:	713-272-8707

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

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	07/09/2007

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