Provider Demographics
NPI:1104042464
Name:NGUYEN, AIMEE L (MD)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:L
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3140 LEGACY DR
Mailing Address - Street 2:STE 210
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-6008
Mailing Address - Country:US
Mailing Address - Phone:469-234-8888
Mailing Address - Fax:469-234-8894
Practice Address - Street 1:3140 LEGACY DR
Practice Address - Street 2:STE 210
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-6008
Practice Address - Country:US
Practice Address - Phone:469-234-8888
Practice Address - Fax:469-234-8894
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-114795207V00000X
TXN5283207VF0040X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyFemale Pelvic Medicine and Reconstructive Surgery
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXN5283OtherTX STATE LIC
IL036-114795OtherIL STATE LIC