MEDICARE: CHAU DONG 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
1	207RC0000X	Cardiovascular Disease Physician	L0876	TX

General Provider Information

NPI Number	:	1639149453
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHAU DONG NGUYEN MD

Provider Business Mailing Address
First Line	:	PO BOX 540088
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77254-0088
Country	:	US
Telephone Number	:	713-850-1190
Fax Number	:	713-850-1327

Provider Business Practice Location Address
First Line	:	11920 ASTORIA BLVD
Second Line	:	SUITE 300
City	:	HOUSTON
State	:	TX
Zip	:	77089-6097
Country	:	US
Telephone Number	:	713-946-8951
Fax Number	:	713-946-0875

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

Provider Enumeration Date	:	01/24/2006
Last Update Date	:	11/22/2010

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