Provider Demographics
NPI:1184882573
Name:NGUYEN, MINH V (DO)
Entity type:Individual
Prefix:DR
First Name:MINH
Middle Name:V
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 1:1669 S 9TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:TX
Mailing Address - Zip Code:76065-3754
Mailing Address - Country:US
Mailing Address - Phone:817-473-9473
Mailing Address - Fax:214-504-2435
Practice Address - Street 1:1669 S 9TH ST STE 100
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:TX
Practice Address - Zip Code:76065-3754
Practice Address - Country:US
Practice Address - Phone:817-473-9473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-02
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN3209207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX204091701Medicaid
TXP00740650OtherRAILROAD MCARE THRU AEMA
TX204091704Medicaid
IL05-0540914OtherTAX-ID
TX204091702Medicaid
IL036119785OtherIL LICENSE
IL036119785OtherIL LICENSE
TXTXB115449Medicare PIN
TX8L14865Medicare PIN