Thanh Van Nguyen MD PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

78-65 Issued in NM

Legal business name

THANH VAN NGUYEN MD PA

Practice address

309 E Washington Ave
Tucumcari, NM 88401-3873

Phone

(575) 461-2616

Fax

(575) 461-1342

NPI assigned

Nov 21, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Thanh Van Nguyen, MD

Title

Owner

Phone

(575) 461-2616

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1227225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227312000000",
    "number": "1346495082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 966",
            "city": "TUCUMCARI",
            "state": "NM",
            "postal_code": "884010966",
            "telephone_number": "575-461-2616",
            "fax_number": "575-461-1342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 E WASHINGTON AVE",
            "city": "TUCUMCARI",
            "state": "NM",
            "postal_code": "884013873",
            "telephone_number": "575-461-2616",
            "fax_number": "575-461-1342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THANH VAN NGUYEN MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-21",
        "last_updated": "2008-11-22",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "THANH",
        "authorized_official_middle_name": "VAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "575-461-2616",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "78-65",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "19737",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.