Provider Demographics
NPI:1043702012
Name:NGUYEN, TUYET-TRINH KATIE (PA)
Entity Type:Individual
Prefix:MS
First Name:TUYET-TRINH
Middle Name:KATIE
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 KAREN DR
Mailing Address - Street 2:
Mailing Address - City:CHALMETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70043-2511
Mailing Address - Country:US
Mailing Address - Phone:504-352-0510
Mailing Address - Fax:
Practice Address - Street 1:6411 E NORTHWEST HWY STE 120
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-8007
Practice Address - Country:US
Practice Address - Phone:469-495-9110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-05
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA308912363A00000X
TXPA17062363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant