Provider Demographics
NPI:1629273271
Name:NGUYEN, SON XUAN (MD)
Entity Type:Individual
Prefix:
First Name:SON
Middle Name:XUAN
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 1:400 W ARBROOK BLVD
Mailing Address - Street 2:SUITE 331
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76014-3174
Mailing Address - Country:US
Mailing Address - Phone:807-468-7000
Mailing Address - Fax:817-468-7003
Practice Address - Street 1:400 W ARBROOK BLVD
Practice Address - Street 2:SUITE 331
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-3174
Practice Address - Country:US
Practice Address - Phone:807-468-7000
Practice Address - Fax:817-468-7003
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM5855208600000X, 2086S0122X, 208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8CV581OtherBCBS INDIVIDUAL #
TX8CV581OtherBCBS INDIVIDUAL #