Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 9324 | TX |
NPI | 1003805912 |
---|---|
Provider Name | Dr. Thien Nguyen |
First Address | Watauga, TX 76148-2541 |
Second Address | Watauga, TX 76148-2541 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2005 |
Last Update Date | 23/06/2008 |