1922069624 NPI number — ALEX P NGUYEN M. D.

Table of content: ALEX P NGUYEN M. D. (NPI 1922069624)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922069624 NPI number — ALEX P NGUYEN M. D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NGUYEN
Provider First Name:
ALEX
Provider Middle Name:
P
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M. D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1922069624
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/23/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
902 FROSTWOOD DR
Provider Second Line Business Mailing Address:
SUITE 315
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77024-2420
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-800-0656
Provider Business Mailing Address Fax Number:
713-827-1380

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
925 GESSNER
Provider Second Line Business Practice Location Address:
SUITE 600
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77024-2545
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-827-9525
Provider Business Practice Location Address Fax Number:
713-468-3561
Provider Enumeration Date:
03/31/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RH0003X , with the licence number:  L8452 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 7659601 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2322957 . This is a "BLUELINK" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 8V3231 . This is a "BLUE CHOICE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 10036694 . This is a "AMERIGROUP" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 176252801 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".