1568779742 NPI number — DAN DINH NGUYEN D.O. P.A.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568779742 NPI number — DAN DINH NGUYEN D.O. P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DAN DINH NGUYEN D.O. P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1568779742
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/13/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12879 JOSEY LN
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
FARMERS BRANCH
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75234-6396
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-247-3600
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12879 JOSEY LN
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
FARMERS BRANCH
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75234-6396
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-247-3600
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/08/2010

Additional Information

Authorized Official

Authorized Official Last Name:
NGUYEN
Authorized Official First Name:
DAN
Authorized Official Middle Name:
DINH
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
972-247-3600

Provider Taxonomy Codes

  • Taxonomy code: 207QA0505X , with the licence number:  L6126 , 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)





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