Provider Demographics
NPI:1154454304
Name:TUAN D NGUYEN, DO, PA
Entity Type:Organization
Organization Name:TUAN D NGUYEN, DO, PA
Other - Org Name:ARLINGTON URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADM
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KIDWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-731-6121
Mailing Address - Street 1:3295 S COOPER ST STE 101
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76015-2359
Mailing Address - Country:US
Mailing Address - Phone:817-557-9616
Mailing Address - Fax:
Practice Address - Street 1:3295 S COOPER ST STE 101
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015-2359
Practice Address - Country:US
Practice Address - Phone:817-557-9616
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXI1680207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0023MNOtherTX GROUP BCBS
TX180067401Medicaid
DF0156OtherMEDICARE RAILROAD
DF0156OtherMEDICARE RAILROAD
TX0023MNOtherTX GROUP BCBS