Provider Demographics
NPI:1669500146
Name:NGUYEN, MICHAEL MINH (DC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:MINH
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 E SEMINARY DR STE 250
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76115-2653
Mailing Address - Country:US
Mailing Address - Phone:817-926-1999
Mailing Address - Fax:817-926-1990
Practice Address - Street 1:220 E SEMINARY DR STE 250
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76115-2653
Practice Address - Country:US
Practice Address - Phone:817-926-1999
Practice Address - Fax:817-926-1990
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2012-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10553111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor