Provider Demographics
NPI:1114993193
Name:NGUYEN, TOKO COUNG DUC (PT, MS, OCS, FAAOMPT)
Entity Type:Individual
Prefix:
First Name:TOKO
Middle Name:COUNG DUC
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:PT, MS, OCS, FAAOMPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 AVENUE E
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-5801
Mailing Address - Country:US
Mailing Address - Phone:281-499-7539
Mailing Address - Fax:281-499-7575
Practice Address - Street 1:711 AVENUE E
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-5801
Practice Address - Country:US
Practice Address - Phone:281-499-7539
Practice Address - Fax:281-499-7575
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1151027225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist