Provider Demographics
NPI:1295971893
Name:NGUYEN-OGHALAI RHEUMATOLOGY, PA
Entity type:Organization
Organization Name:NGUYEN-OGHALAI RHEUMATOLOGY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:U
Authorized Official - Last Name:NGUYEN-OGHALAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-202-8217
Mailing Address - Street 1:3015 TAYLORCREST DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-9166
Mailing Address - Country:US
Mailing Address - Phone:713-202-8217
Mailing Address - Fax:
Practice Address - Street 1:12924 BELLAIRE BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77072-5131
Practice Address - Country:US
Practice Address - Phone:713-202-8217
Practice Address - Fax:713-457-4200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-02
Last Update Date:2009-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207K00000X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty