Provider Demographics
NPI:1376737189
Name:DONG V NGUYEN, DPM PA
Entity Type:Organization
Organization Name:DONG V NGUYEN, DPM PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONG
Authorized Official - Middle Name:V
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:817-801-5704
Mailing Address - Street 1:1321 E PIONEER PKWY
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76010-5868
Mailing Address - Country:US
Mailing Address - Phone:817-801-5704
Mailing Address - Fax:817-801-5707
Practice Address - Street 1:925 WRIGHT ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-4731
Practice Address - Country:US
Practice Address - Phone:817-801-5704
Practice Address - Fax:817-801-5707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-05
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QP1100X261QP1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0083QCOtherBCBS OF TX
TX0083QCOtherBCBS OF TX
TX6136540001Medicare NSC
TX00Y135Medicare PIN