Provider Demographics
NPI:1356594378
Name:HUNG THE NGUYEN, MDPA
Entity type:Organization
Organization Name:HUNG THE NGUYEN, MDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HUNG
Authorized Official - Middle Name:THE
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-801-5704
Mailing Address - Street 1:925 WRIGHT ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012-4731
Mailing Address - Country:US
Mailing Address - Phone:817-801-5704
Mailing Address - Fax:817-801-5707
Practice Address - Street 1:925 WRIGHT ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-4731
Practice Address - Country:US
Practice Address - Phone:817-801-5704
Practice Address - Fax:817-801-5707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-04
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM5854261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00Z941Medicare PIN