Provider Demographics
NPI:1942417787
Name:NGUYEN, CHRISTOPHER VINH (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:VINH
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 2386
Mailing Address - Street 2:BRAZOS VALLEY PATHOLOGY
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664
Mailing Address - Country:US
Mailing Address - Phone:903-504-7647
Mailing Address - Fax:512-597-2713
Practice Address - Street 1:800 E. DAWSON
Practice Address - Street 2:TRINITY MOTHER FRANCES HOSPITAL
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-2036
Practice Address - Country:US
Practice Address - Phone:512-814-0298
Practice Address - Fax:512-597-2713
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD430650207ZP0102X
WI53269207ZP0102X
TXN1799207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3004723Medicaid
TXTXB155346OtherMEDICARE
WI651900070Medicare PIN
WI020450069Medicare PIN
WI602400071Medicare PIN
WI525100071Medicare PIN
WI070450064Medicare PIN