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Organization

VINH NGUYEN, MD, PA

Active
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Organization

VINH NGUYEN, MD, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. VINH H NGUYEN M.D (PRESIDENT)
(432) 349-2891
Entity
Organization

Contact information

Practice address
420 E 6TH ST, SUITE 200, ODESSA, TX 79761-4529
(432) 582-8998
(432) 582-8997
Mailing address
6915 STONEHENGE RD, ODESSA, TX 79765-8924
(432) 349-2891

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
L3770
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
160635208
—
TX
01
—
1952308934
NPI TYPE 1 ENTITY
TX
01
—
212367101
PA MEDICAID
TX
01
—
212367102
PA MEDICAID THSTEPS
TX
Enumeration date
06/22/2010
Last updated
10/12/2011
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