Provider Demographics
NPI:1639149453
Name:NGUYEN, CHAU DONG (MD)
Entity Type:Individual
Prefix:
First Name:CHAU
Middle Name:DONG
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 540088
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77254-0088
Mailing Address - Country:US
Mailing Address - Phone:713-850-1190
Mailing Address - Fax:713-850-1327
Practice Address - Street 1:11920 ASTORIA BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77089-6097
Practice Address - Country:US
Practice Address - Phone:713-946-8951
Practice Address - Fax:713-946-0875
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL0876207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
G42958Medicare UPIN