Provider Demographics
NPI:1548405103
Name:HOWARD H. NGUYEN D.O. PA
Entity Type:Organization
Organization Name:HOWARD H. NGUYEN D.O. PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:H
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:214-630-9559
Mailing Address - Street 1:PO BOX 630615
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-0130
Mailing Address - Country:US
Mailing Address - Phone:214-630-9559
Mailing Address - Fax:214-630-4992
Practice Address - Street 1:2261 SINGLETON BLVD
Practice Address - Street 2:101
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75212-5050
Practice Address - Country:US
Practice Address - Phone:214-630-9559
Practice Address - Fax:214-630-4992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-11
Last Update Date:2008-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0959207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX121328205Medicaid
TX1932174711OtherNPI
TX121328205Medicaid