MEDICARE: ANGELA NGUYEN D.O.

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	207Q00000X	Family Medicine Physician	R7546	TX
2	207Q00000X	Family Medicine Physician	BP10056104	TX

General Provider Information

NPI Number	:	1770939837
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA NGUYEN D.O.

Provider Business Mailing Address
First Line	:	4100 N COLLINS ST STE 200
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76005-4551
Country	:	US
Telephone Number	:	817-860-1309
Fax Number	:	817-860-5380

Provider Business Practice Location Address
First Line	:	2730 SW WILSHIRE BLVD
Second Line	:
City	:	BURLESON
State	:	TX
Zip	:	76028-8338
Country	:	US
Telephone Number	:	817-916-5180
Fax Number	:	817-916-5199

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

Provider Enumeration Date	:	05/09/2016
Last Update Date	:	03/06/2026

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