Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 30814 | TX |
NPI | 1083056543 |
---|---|
Provider Name | Dr. Tam T Nguyen |
First Address | Richmond, TX 77407-5419 |
Second Address | Richmond, TX 77407-5419 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2013 |
Last Update Date | 18/11/2021 |