Provider Demographics
NPI:1316163942
Name:NGUYEN, TAN MINH (MD)
Entity type:Individual
Prefix:DR
First Name:TAN
Middle Name:MINH
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2825 OAK LAWN AVE UNIT 192749
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-4688
Mailing Address - Country:US
Mailing Address - Phone:510-683-9500
Mailing Address - Fax:877-880-2039
Practice Address - Street 1:2825 OAK LAWN AVE UNIT 192749
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-4688
Practice Address - Country:US
Practice Address - Phone:510-683-9500
Practice Address - Fax:877-880-2039
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT732662085R0202X
CAA858722085R0202X
NC2023-000382085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology