Provider Demographics
NPI:1366440059
Name:NGUYEN, WYN DINH (MD)
Entity Type:Individual
Prefix:DR
First Name:WYN
Middle Name:DINH
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 1:700 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:ANDREWS
Mailing Address - State:TX
Mailing Address - Zip Code:79714-3638
Mailing Address - Country:US
Mailing Address - Phone:432-523-6624
Mailing Address - Fax:432-524-1129
Practice Address - Street 1:700 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:ANDREWS
Practice Address - State:TX
Practice Address - Zip Code:79714-3638
Practice Address - Country:US
Practice Address - Phone:432-523-6624
Practice Address - Fax:432-524-1129
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL4605208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F6739Medicare PIN
TX8F6740Medicare PIN
TX00Y434Medicare PIN
TX00Y435Medicare PIN