Provider Demographics
NPI:1023123783
Name:GIANG T. NGUYEN, MD, PA
Entity type:Organization
Organization Name:GIANG T. NGUYEN, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GIANG
Authorized Official - Middle Name:TUONG
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-665-2525
Mailing Address - Street 1:PO BOX 222
Mailing Address - Street 2:
Mailing Address - City:PAMPA
Mailing Address - State:TX
Mailing Address - Zip Code:79066-0222
Mailing Address - Country:US
Mailing Address - Phone:806-665-2525
Mailing Address - Fax:
Practice Address - Street 1:2218 N HOBART ST
Practice Address - Street 2:
Practice Address - City:PAMPA
Practice Address - State:TX
Practice Address - Zip Code:79065-3418
Practice Address - Country:US
Practice Address - Phone:806-665-2525
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL4194208000000X, 208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
No208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX153040401Medicaid
TXTXB149780OtherMEDICARE PTAN
TXH66705Medicare UPIN