Provider Demographics
NPI:1639312697
Name:NGUYEN, CAMERAN (DO)
Entity Type:Individual
Prefix:DR
First Name:CAMERAN
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 CROWN POINTE BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:WILLOW PARK
Mailing Address - State:TX
Mailing Address - Zip Code:76087-1309
Mailing Address - Country:US
Mailing Address - Phone:817-482-0000
Mailing Address - Fax:
Practice Address - Street 1:211 CROWN POINTE BLVD STE 300
Practice Address - Street 2:
Practice Address - City:WILLOW PARK
Practice Address - State:TX
Practice Address - Zip Code:76087-1309
Practice Address - Country:US
Practice Address - Phone:817-482-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-07
Last Update Date:2023-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR3924207ZP0102X, 207ZD0900X
SCDO82995207ZD0900X
ALDO.1421207ZH0000X
OK5304207ZP0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematology
No207ZP0007XAllopathic & Osteopathic PhysiciansPathologyMolecular Genetic Pathology