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NPI Code Detail

MEDICARE: MIMI NGUYEN DO

MEDICARE: MIMI NGUYEN DO
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
1207Q00000XFamily Medicine PhysicianW2761TX
2207Q00000XFamily Medicine Physician324261LA

General Provider Information

NPI Number : 1780114074
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIMI NGUYEN DO
Provider Business Mailing Address
First Line : PO BOX 919229
Second Line :
City : DALLAS
State : TX
Zip : 75391-9229
Country : US
Telephone Number : 337-289-8944
Fax Number : 337-571-0010
Provider Business Practice Location Address
First Line : 4212 W CONGRESS ST STE 1600
Second Line :
City : LAFAYETTE
State : LA
Zip : 70506-6767
Country : US
Telephone Number : 337-456-1642
Fax Number : 337-456-4913
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2017
Last Update Date : 03/04/2026

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Directions to “ MIMI NGUYEN DO” Practice Location

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