Provider Demographics
NPI:1093976342
Name:NGUYEN, MICHAEL VAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:VAN
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 BUSINESS CENTER DR STE 201
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77043-2744
Mailing Address - Country:US
Mailing Address - Phone:713-932-5757
Mailing Address - Fax:713-932-5750
Practice Address - Street 1:9250 PINECROFT DRIVE
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-3218
Practice Address - Country:US
Practice Address - Phone:269-337-4400
Practice Address - Fax:281-364-2535
Is Sole Proprietor?:No
Enumeration Date:2008-06-19
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301092606207P00000X, 390200000X
TXP7821207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program