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Organization

EDGE-MD ILLINOIS, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. NATHAN P. NGUYEN MD (OWNER/MD)
(979) 532-2000
Entity
Organization

Contact information

Practice address
2304 W ILLINOIS AVE, DALLAS, TX 75224-1638
(214) 337-7200
(214) 337-7206
Mailing address
2022 REGIONAL MEDICAL DR, SUITE 1315, WHARTON, TX 77488-7231
(979) 532-2000
(979) 532-2008

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
N0318
TX

Other

Enumeration date
09/03/2014
Last updated
01/13/2015
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