Provider Demographics
NPI:1568779742
Name:DAN DINH NGUYEN D.O. P.A.
Entity Type:Organization
Organization Name:DAN DINH NGUYEN D.O. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAN
Authorized Official - Middle Name:DINH
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:972-247-3600
Mailing Address - Street 1:12879 JOSEY LN
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FARMERS BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:75234-6396
Mailing Address - Country:US
Mailing Address - Phone:972-247-3600
Mailing Address - Fax:
Practice Address - Street 1:12879 JOSEY LN
Practice Address - Street 2:SUITE 100
Practice Address - City:FARMERS BRANCH
Practice Address - State:TX
Practice Address - Zip Code:75234-6396
Practice Address - Country:US
Practice Address - Phone:972-247-3600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-08
Last Update Date:2011-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6126207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXI50443Medicare UPIN