Provider Demographics
NPI:1346395613
Name:NGUYEN, DIANE PHUONG (DO)
Entity Type:Individual
Prefix:DR
First Name:DIANE
Middle Name:PHUONG
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:2303 RANCH ROAD 620 S
Mailing Address - Street 2:STE 135, PMB 125
Mailing Address - City:LAKEWAY
Mailing Address - State:TX
Mailing Address - Zip Code:78734-6219
Mailing Address - Country:US
Mailing Address - Phone:512-502-4556
Mailing Address - Fax:512-263-9975
Practice Address - Street 1:1010 RANCH ROAD 620 S
Practice Address - Street 2:STE 108
Practice Address - City:LAKEWAY
Practice Address - State:TX
Practice Address - Zip Code:78734-5636
Practice Address - Country:US
Practice Address - Phone:512-502-4556
Practice Address - Fax:512-263-9975
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2012-10-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXL88632084P0800X, 2084P0802X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry