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932 E Tidwell Rd Houston TX 77022-1826 | |
| (713) 691-0555 | |
| (713) 691-0921 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 932 E Tidwell Rd, Houston, Texas |
| Authorized Official Name and Position | Trong Duc Nguyen (DENTIST) |
| Authorized Official Contact | 7136910555 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
932 E Tidwell Rd Houston TX 77022-1826 Ph: (713) 691-0555 | 932 E Tidwell Rd Houston TX 77022-1826 Ph: (713) 691-0555 |
| NPI Number | 1447422290 |
|---|---|
| Provider Enumeration Date | 04/01/2008 |
| Last Update Date | 04/23/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447422290 | NPI | - | NPPES |
| 126807004 | Medicaid | TX | |
| 1952186041 | Medicaid | TX | |
| 975552 | Other | TX | UNITED CONCORDIA |
| TEX60 | Other | TX | TEXAS CHIP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 17939 (Texas) | Primary |
| 1223G0001X | Dentist - General Practice | 23050 (Texas) | Secondary |
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