Provider Demographics
NPI:1073093779
Name:NGUYEN, DONGBAO HUA
Entity Type:Individual
Prefix:DR
First Name:DONGBAO
Middle Name:HUA
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 PARK HARBOR OAKS CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-5689
Mailing Address - Country:US
Mailing Address - Phone:713-885-1132
Mailing Address - Fax:
Practice Address - Street 1:1515 PARK HARBOR OAKS CT
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-5689
Practice Address - Country:US
Practice Address - Phone:713-885-1132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-21
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63123183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist