Provider Demographics
NPI:1114195724
Name:NGUYEN, PAUL THO (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:THO
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 1:13421 WESTHEIMER RD STE D
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-3772
Mailing Address - Country:US
Mailing Address - Phone:281-947-5974
Mailing Address - Fax:281-947-5977
Practice Address - Street 1:13421 WESTHEIMER RD STE D
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-3772
Practice Address - Country:US
Practice Address - Phone:281-947-5974
Practice Address - Fax:281-947-5977
Is Sole Proprietor?:No
Enumeration Date:2008-02-16
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP0454207Q00000X, 207P00000X
LA202973207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1077941Medicaid
LA4M223Medicare PIN