Provider Demographics
NPI:1558458851
Name:NGUYEN, BICH VAN (MD)
Entity Type:Individual
Prefix:
First Name:BICH
Middle Name:VAN
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10904 SCARSDALE BLVD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77089-6068
Mailing Address - Country:US
Mailing Address - Phone:281-484-0449
Mailing Address - Fax:281-484-7210
Practice Address - Street 1:10904 SCARSDALE BLVD
Practice Address - Street 2:SUITE 150
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77089-6068
Practice Address - Country:US
Practice Address - Phone:281-484-0449
Practice Address - Fax:281-484-7210
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXH2956207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXD90895Medicare UPIN
TX8C7756Medicare ID - Type Unspecified