Provider Demographics
NPI:1982773784
Name:NGUYEN, TUAN ALEX (MD)
Entity Type:Individual
Prefix:DR
First Name:TUAN
Middle Name:ALEX
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 1:2825 NW 23RD ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73107-2213
Mailing Address - Country:US
Mailing Address - Phone:405-525-1975
Mailing Address - Fax:405-208-4096
Practice Address - Street 1:2825 NW 23RD ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73107-2213
Practice Address - Country:US
Practice Address - Phone:405-525-1975
Practice Address - Fax:405-208-4096
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK20755207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK731613065001OtherBLUECROSS BLUESHELD
OK731613065001OtherBLUECROSS BLUESHELD