Individual
JIM NGUYEN
Active
Individual
JIM NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
PA20097
CA
363AS0400X
Surgical Physician Assistant
Primary
PA01648
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1447498746
BLUE CROSS BLUE SHIELD
TX
05
—
218712202
—
TX
05
—
218712203
—
TX
01
—
8408ND
BLUE CROSS BLUE SHIELD
TX
01
—
877N87
BLUE CROSS BLUE SHIELD
TX
01
—
P01186474
RR MEDICARE
TX
01
—
P01258270
MEDICARE RR
TX
Enumeration date
01/26/2009
Last updated
02/24/2014
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