Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | K1585 | TX |
N | 207QA0505X | Family Doctor - Adult Medicine | K1585 | TX |
NPI | 1205852068 |
---|---|
Provider Name | Dr. Chau Ngoc Nguyen |
First Address | Houston, TX 77036-2131 |
Second Address | Houston, TX 77036-2131 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 15/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0038AS | MEDICARE (01) | TX |
E99988 | UPIN (01) | TX |
K1585 | LICENSE (01) | TX |