Provider Demographics
NPI:1285642504
Name:NGUYEN, CUONG M (MD)
Entity Type:Individual
Prefix:
First Name:CUONG
Middle Name:M
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 1:14090 SOUTHWEST FWY STE 101
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3678
Mailing Address - Country:US
Mailing Address - Phone:281-313-1193
Mailing Address - Fax:
Practice Address - Street 1:14090 SOUTHWEST FWY STE 101
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3678
Practice Address - Country:US
Practice Address - Phone:281-313-1193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ1549207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXJ1549OtherSTATE LICENCE
TX0043HDOtherBCBS
TX2623540OtherAETNA
TX00111TMedicare ID - Type Unspecified
TX2623540OtherAETNA