Organization
THANH VAN NGUYEN MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THANH VAN NGUYEN MD (OWNER)
(575) 461-2616
Entity
Organization
Contact information
Practice address
309 E WASHINGTON AVE, TUCUMCARI, NM 88401-3873
(575) 461-2616
(575) 461-1342
Mailing address
PO BOX 966, TUCUMCARI, NM 88401-0966
(575) 461-2616
(575) 461-1342
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
78-65
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
19737
—
NM
Enumeration date
11/21/2008
Last updated
11/22/2008
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