Provider Demographics
NPI:1033301056
Name:NGUYEN, NGUYET ANH (MMS, PA-C)
Entity Type:Individual
Prefix:
First Name:NGUYET
Middle Name:ANH
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MMS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 EVENING SONG CT
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-4218
Mailing Address - Country:US
Mailing Address - Phone:504-251-0804
Mailing Address - Fax:
Practice Address - Street 1:314 SAWDUST RD
Practice Address - Street 2:119
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-2347
Practice Address - Country:US
Practice Address - Phone:281-292-3030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-14
Last Update Date:2015-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
TXPA07542363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health