Provider Demographics
NPI: | 1811275464 |
---|---|
Name: | NGUYEN, TUAN L (PT, DPT) |
Entity type: | Individual |
Prefix: | DR |
First Name: | TUAN |
Middle Name: | L |
Last Name: | NGUYEN |
Suffix: | |
Gender: | M |
Credentials: | PT, DPT |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 9354 BROWNLEY DR |
Mailing Address - Street 2: | |
Mailing Address - City: | OMAHA |
Mailing Address - State: | NE |
Mailing Address - Zip Code: | 68134-5722 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 402-215-6954 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 8525 Q ST |
Practice Address - Street 2: | |
Practice Address - City: | OMAHA |
Practice Address - State: | NE |
Practice Address - Zip Code: | 68127-3604 |
Practice Address - Country: | US |
Practice Address - Phone: | 402-339-1108 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2011-08-01 |
Last Update Date: | 2011-10-20 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NE | 2459 | 225100000X, 2251C2600X, 2251E1200X, 2251G0304X, 2251N0400X, 2251P0200X, 2251S0007X, 2251X0800X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | |
No | 2251C2600X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Cardiopulmonary |
No | 2251E1200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Ergonomics |
No | 2251G0304X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Geriatrics |
No | 2251N0400X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Neurology |
No | 2251P0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Pediatrics |
No | 2251S0007X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Sports |
No | 2251X0800X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
NE | 099668 | Medicare PIN | |
NE | 099668008 | Medicare PIN |