Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0003X | Hematology & Oncology | DO1698 | TN |
Y | 207RH0003X | Hematology & Oncology | M3045 | TX |
NPI | 1023233756 |
---|---|
Provider Name | Diane Duyen T Nguyen |
First Address | Lubbock, TX 79408-5865 |
Second Address | Lubbock, TX 79415-3364 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2007 |
Last Update Date | 04/01/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4155051 | BCBS OF TN (01) | TN |