MEDICARE: DR. HUNG THANH NGUYEN M.D.

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	207R00000X	Internal Medicine Physician	L7073	TX

General Provider Information

NPI Number	:	1790784288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HUNG THANH NGUYEN M.D.

Provider Business Mailing Address
First Line	:	15606 KELLAN CT
Second Line	:
City	:	CYPRESS
State	:	TX
Zip	:	77429-6115
Country	:	US
Telephone Number	:	281-351-5235
Fax Number	:	281-351-5235

Provider Business Practice Location Address
First Line	:	11810 FM 1960 W
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77065-3840
Country	:	US
Telephone Number	:	832-912-7111
Fax Number	:	832-912-7117

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

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	07/09/2007

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