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Provider Information for 1063513299



TAM M NGUYEN DDS

Gender: FEMALE

Individual NPI: 1063513299

Calendar Last Updated: 2007-07-08

Details

Name Value
NPI 1063513299
Enumeration Date 2006-09-26
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 2201 DOUBLE CREEK DR #2001
ROUND ROCK, TX 78664-3836
United States

Phone: 512-310-0330 | Fax: 512-310-0901
View Map External Link
Primary Practice Address 2201 DOUBLE CREEK DR #2001
ROUND ROCK, TX 78664-3836
United States

Phone: 512-310-0330 | Fax: 512-310-0901
View Map External Link
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice TX 19825
Other Identifiers
Issuer State Number
Endpoint Information
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location