MEDICARE: NGOC-OANH NGUYEN-TONG D.C.

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	111N00000X	Chiropractor	8584	TX

General Provider Information

NPI Number	:	1720015167
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NGOC-OANH NGUYEN-TONG D.C.

Provider Business Mailing Address
First Line	:	7219 CANARY LN
Second Line	:
City	:	SACHSE
State	:	TX
Zip	:	75048-2147
Country	:	US
Telephone Number	:	469-693-5255
Fax Number	:	972-675-3202

Provider Business Practice Location Address
First Line	:	2636 W WALNUT ST
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75042-6441
Country	:	US
Telephone Number	:	972-487-5800
Fax Number	:	214-703-9001

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

Provider Enumeration Date	:	06/28/2006
Last Update Date	:	11/14/2007

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