Provider Demographics
NPI:1356351449
Name:NGUYEN, GIAM (DO)
Entity type:Individual
Prefix:DR
First Name:GIAM
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2110 JEFFERSON ST
Mailing Address - Street 2:SUITE 107
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77003-5100
Mailing Address - Country:US
Mailing Address - Phone:713-224-5887
Mailing Address - Fax:713-224-5388
Practice Address - Street 1:2110 JEFFERSON ST
Practice Address - Street 2:SUITE 107
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77003-5100
Practice Address - Country:US
Practice Address - Phone:713-224-5887
Practice Address - Fax:713-224-5388
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2009-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL9394207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
I16157Medicare UPIN
8C1869Medicare ID - Type Unspecified