Provider Demographics
NPI:1275534976
Name:NGUYEN, ANH THI (MD)
Entity Type:Individual
Prefix:
First Name:ANH
Middle Name:THI
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 1:5 PECAN GORGE CT
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-5935
Mailing Address - Country:US
Mailing Address - Phone:832-741-6105
Mailing Address - Fax:281-313-1194
Practice Address - Street 1:5 PECAN GORGE CT
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-5935
Practice Address - Country:US
Practice Address - Phone:832-741-6105
Practice Address - Fax:281-313-1194
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-03
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH4842207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP000LS7EOMedicaid
TX445998164Medicaid
TXP000LS7EOMedicaid
G12629Medicare UPIN