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Audrey Ngoc Nguyen

Internal Medicine

Allopathic & Osteopathic Physicians

6431 Fannin St, Msb 1.274, Houston, TX 77030

PECOS Enrollment

This provider is enrolled in PECOS as AUDREY NGUYEN.

Based on the most recent information from CMS, provider Audrey Ngoc Nguyen is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 8:41 AM.

Profile Details

Provider ID
1205030889
Provider Type
Individual
Full Name
Nguyen, Audrey Ngoc
Title
Dr.
Credential
MD

Gender
Female
Sole Proprietor
No
Enumeration Date
6/14/2007
Last Updated
8/7/2018

Contact Information

Practice Location

6431 Fannin St, Msb 1.274, Houston, TX 77030

(713) 500-6833

Unlisted Fax

Mailing Location

7 Briar Dale Ct Apt A, Houston, TX 77027-2925

(512) 577-3321

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207RP1001X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License P4213 Texas
Code 207RC0200X	Description Internal Medicine Allopathic & Osteopathic Physicians	License P4213 Texas

Provider Identifiers

ID	Description	Issuer
ID 3858306766	Description Other	Issuer MYUTMB 3858306766-COMMERCIAL NUMBER

Audrey Ngoc Nguyen

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Nguyen, Phuong-Dung Julie

Hanania, Nicola

Kley, Adam Christopher

Roman, Ana Estela

Botros, Mena

Sabath, Bruce Fernando

Ross, Robert Marshal

Sasieta, Humberto Carlos

Grosu, Horiana Bogdana

Lodato, Robert F