Individual
PHONG TIEN NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
710 E 6TH ST, ODESSA, TX 79761-4655
(254) 245-9175
Mailing address
PO BOX 11538, KILLEEN, TX 76547-1538
(254) 245-9175
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
OS015620
PA
207L00000X
Anesthesiology Physician
Primary
Q9695
TX
207LP2900X
Pain Medicine (Anesthesiology) Physician
OS015620
PA
207LP2900X
Pain Medicine (Anesthesiology) Physician
Q9695
TX
Other
Enumeration date
07/25/2007
Last updated
11/18/2024
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