Provider Demographics
NPI:1275716920
Name:NGUYEN, HOA X (MD)
Entity Type:Individual
Prefix:DR
First Name:HOA
Middle Name:X
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 1:3819 24TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1829
Mailing Address - Country:US
Mailing Address - Phone:806-797-7000
Mailing Address - Fax:806-797-7055
Practice Address - Street 1:3819 24TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1829
Practice Address - Country:US
Practice Address - Phone:806-797-7000
Practice Address - Fax:806-797-7055
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-17
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK2363174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX045770702Medicaid
TX8G2211OtherBCBS
TX045770702Medicaid
TX8G2211OtherBCBS