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NPI Code Detail

MEDICARE: LE THAO NGUYEN NP

MEDICARE: LE THAO NGUYEN NP
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
1363LF0000XFamily Nurse Practitioner743386TX

General Provider Information

NPI Number : 1801212642
Entity Type Code : Individual
Provider Name (Legal Business Name) : LE THAO NGUYEN NP
Provider Business Mailing Address
First Line : 2550 RIVER PARK PLZ
Second Line : SUITE 110
City : FORT WORTH
State : TX
Zip : 76116-0920
Country : US
Telephone Number : 817-731-1289
Fax Number : 817-731-1291
Provider Business Practice Location Address
First Line : 2550 RIVER PARK PLZ
Second Line : SUITE 110
City : FORT WORTH
State : TX
Zip : 76116-0920
Country : US
Telephone Number : 817-731-1289
Fax Number : 817-731-1291
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2014
Last Update Date : 10/06/2015

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Directions to “ LE THAO NGUYEN NP” Practice Location

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