Individual provider Active NPI

Tram Anh Nguyen, M.D.

  • Family Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1619235405
Registry record updated Jan 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
Q5880 Issued in TX
Practice address
4561 Heritage Trace Pkwy Ste 109
Fort Worth, TX 76244-8907
Phone
(682) 200-0022
NPI assigned
Apr 30, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Q5880 TX Primary

Addresses

Primary practice location

4561 Heritage Trace Pkwy Ste 109
Fort Worth, TX 76244-8907

Mailing address

4561 Heritage Trace Pkwy Ste 109
Fort Worth, TX 76244-8907
Phone (682) 200-0022

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151112000156 TX Practitioner - Family Practice 0749590362

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
Q5880TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Global Wound Care Medical Group CurrentSince May 6, 2024 Accepting new patients

Locations

5901 W Century Blvd
Ste 750
Los Angeles, CA 90045
Phone (323) 843-2861

2400 Augusta Dr
Ste 369
Houston, TX 77057
Phone (323) 545-4007

2400 Augusta Dr
Ste 366
Houston, TX 77057
Phone (346) 362-5344

Interoperability endpoints

  • Direct secure messaging: tram.nguyen@245880210849796.direct.elationemr.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1335744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514937600000",
    "number": "1619235405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4561 HERITAGE TRACE PKWY STE 109",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762448907",
            "telephone_number": "682-200-0022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4561 HERITAGE TRACE PKWY STE 109",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762448907",
            "telephone_number": "682-200-0022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "TRAM",
        "middle_name": "ANH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-30",
        "last_updated": "2018-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "Q5880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.