Provider Demographics
NPI:1114975554
Name:NGUYEN, BENJAMIN BANG V (MD)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:BANG V
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 1:5375 COIT RD STE 130
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-4914
Mailing Address - Country:US
Mailing Address - Phone:214-619-1910
Mailing Address - Fax:214-619-1914
Practice Address - Street 1:5375 COIT RD STE 130
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-4914
Practice Address - Country:US
Practice Address - Phone:214-619-1910
Practice Address - Fax:214-619-1914
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH94712084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1981087Medicaid
LAF35071Medicare UPIN
LA1981087Medicaid