Provider Demographics
NPI:1891964680
Name:BAO NGUYEN, D.C., P.A.
Entity Type:Organization
Organization Name:BAO NGUYEN, D.C., P.A.
Other - Org Name:QUANTUM CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:DUC
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:210-828-3737
Mailing Address - Street 1:8637 FREDERICKSBURG RD
Mailing Address - Street 2:STE. #149
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-1283
Mailing Address - Country:US
Mailing Address - Phone:210-828-3737
Mailing Address - Fax:210-614-5773
Practice Address - Street 1:8637 FREDERICKSBURG RD
Practice Address - Street 2:STE. #149
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1283
Practice Address - Country:US
Practice Address - Phone:210-828-3737
Practice Address - Fax:210-614-5773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-26
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10288111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty