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NPI Code Detail

MEDICARE: DR. TAN DUONG NGUYEN MD

MEDICARE:  DR. TAN DUONG NGUYEN  MD
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
1207Y00000XOtolaryngology PhysicianLO455TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1639106107
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TAN DUONG NGUYEN MD
Provider Business Mailing Address
First Line : PO BOX 749
Second Line :
City : PHARR
State : TX
Zip : 78577-1614
Country : US
Telephone Number : 956-362-8125
Fax Number : 956-362-8135
Provider Business Practice Location Address
First Line : 1100 E DOVE AVE STE 402
Second Line :
City : MCALLEN
State : TX
Zip : 78504-4684
Country : US
Telephone Number : 956-362-8125
Fax Number : 956-362-8135
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2006
Last Update Date : 07/29/2019

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Directions to “ DR. TAN DUONG NGUYEN MD” Practice Location

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