Provider Demographics
NPI:1104030873
Name:NGUYEN, THI MAI TRAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:THI MAI TRAM
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:THI MAI TRAM
Other - Middle Name:
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:5225 KATY FWY
Mailing Address - Street 2:STE 104
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-2264
Mailing Address - Country:US
Mailing Address - Phone:832-673-0999
Mailing Address - Fax:281-657-2406
Practice Address - Street 1:7036 ANTOINE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77088-6613
Practice Address - Country:US
Practice Address - Phone:281-260-8999
Practice Address - Fax:281-260-8866
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2018-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX165931223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry