# EDGE-MD HALTOM CITY, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457756603
- **Authorized official:** NATHAN P NGUYEN MD (MD/OWNER)
- **Authorized official phone:** (979) 532-2000

## Contact information

- **Practice address:** 3101 DENTON HWY, SUITE 100, HALTOM CITY, TX 76117-3706
- **Practice address phone:** (817) 831-6500
- **Practice address fax:** (817) 831-0775
- **Mailing address:** 2022 REGIONAL MEDICAL DR, SUITE 1315, WHARTON, TX 77488-7231
- **Mailing address phone:** (979) 532-2000
- **Mailing address fax:** (979) 532-2008

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | N0318 | TX | Yes |

## Other

- **Enumeration date:** 10/30/2014
- **Last updated:** 01/13/2015