Basic Information
Provider Information
NPI: 1952341034
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NGUYEN
FirstName: TUAN
MiddleName: DINH
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4616 W HOWARD LN
Address2:  
City: AUSTIN
State: TX
PostalCode: 787286300
CountryCode: US
TelephoneNumber: 5123248960
FaxNumber: 5123248906
Practice Location
Address1: 1301 W 38TH ST
Address2: SUITE 400
City: AUSTIN
State: TX
PostalCode: 787051000
CountryCode: US
TelephoneNumber: 5123243440
FaxNumber: 5124066513
Other Information
ProviderEnumerationDate: 06/07/2006
LastUpdateDate: 07/22/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000XL8455TXY Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
207UN0901XL8455TXN Allopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology

ID Information
IDTypeStateIssuerDescription
18324610605TX MEDICAID
8CR64701TXBCBSOTHER
8ET18301TXBCBSOTHER
18324610805TX MEDICAID
18324610705TX MEDICAID
18324610905TX MEDICAID
P0097627901TXRAILROAD MEDICAREOTHER


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