Provider Demographics
NPI:1437115946
Name:NGUYEN, TAM (MD)
Entity Type:Individual
Prefix:
First Name:TAM
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5865
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79408-5865
Mailing Address - Country:US
Mailing Address - Phone:806-743-2898
Mailing Address - Fax:806-743-2787
Practice Address - Street 1:3502 9TH ST
Practice Address - Street 2:STE 410
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79415-3300
Practice Address - Country:US
Practice Address - Phone:806-743-4115
Practice Address - Fax:806-743-1313
Is Sole Proprietor?:No
Enumeration Date:2006-04-24
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM2422207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX179081801Medicaid
TX8A2678OtherBC/BS
TX146200101OtherFIRSTCARE COMMERCIAL
OK200074720AOtherOK HEALTHCARE AUTHORITY
NM202004124Medicaid
TX8M0737OtherHMO BLUE
TX10142612OtherDPS
NM34920714Medicaid
TX146200102Medicaid
NM202004124OtherPRESBYTERIAN COMMERCIAL
NM202004124OtherPRESBYTERIAN COMMERCIAL