Provider Demographics
NPI:1346866944
Name:NGUYEN, HAI DUC (FNP-C)
Entity Type:Individual
Prefix:
First Name:HAI
Middle Name:DUC
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2965 HARRISON ST STE 222
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77702-1100
Mailing Address - Country:US
Mailing Address - Phone:409-892-1003
Mailing Address - Fax:409-892-2655
Practice Address - Street 1:2965 HARRISON ST STE 222
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77702-1100
Practice Address - Country:US
Practice Address - Phone:409-892-1003
Practice Address - Fax:409-892-2655
Is Sole Proprietor?:No
Enumeration Date:2020-06-19
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP144893363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1346866944Medicaid