Provider Demographics
NPI:1336328426
Name:TODD THANG QUOC NGUYEN, MD, PLLC
Entity Type:Organization
Organization Name:TODD THANG QUOC NGUYEN, MD, PLLC
Other - Org Name:TRANSCEND MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUSTINE
Authorized Official - Middle Name:T
Authorized Official - Last Name:PHAN
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:817-860-7000
Mailing Address - Street 1:1119 W RANDOL MILL RD STE 103
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012-6509
Mailing Address - Country:US
Mailing Address - Phone:817-860-2700
Mailing Address - Fax:817-860-2704
Practice Address - Street 1:1119 W RANDOL MILL RD STE 103
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-6509
Practice Address - Country:US
Practice Address - Phone:817-860-2700
Practice Address - Fax:817-860-2704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-25
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM0513207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0067MTOtherBCBS
TX183238801Medicaid
DE5064OtherMEDICARE RAILROAD
TX183238801Medicaid