Individual
CHAU BAO NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
904 W UNIVERSITY AVE STE 101, GEORGETOWN, TX 78626-6512
(512) 819-0264
(512) 406-6242
Mailing address
6210 E HWY 290, AUSTIN, TX 78723-1142
(512) 483-9596
(512) 406-6216
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
R10587
IA
207R00000X
Internal Medicine Physician
Primary
R9654
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4001752
—
TX
05
—
4001752-02
—
TX
01
—
R9654
TEXAS MEDICAL LICENSE
TX
Enumeration date
07/11/2016
Last updated
11/14/2021
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