Provider Demographics
NPI:1376569582
Name:NGUYEN, HAYLEY (MD)
Entity Type:Individual
Prefix:
First Name:HAYLEY
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5151 KATY FWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-2260
Mailing Address - Country:US
Mailing Address - Phone:713-461-4101
Mailing Address - Fax:713-864-5355
Practice Address - Street 1:5151 KATY FWY
Practice Address - Street 2:SUITE 100
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-2260
Practice Address - Country:US
Practice Address - Phone:713-461-4101
Practice Address - Fax:713-864-5355
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM0197207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00002543047 02OtherUNITED HEALTHCARE ID#
TX11483636OtherCAQH ID#
TX3633943002OtherCIGNA PCP ID#
TX0062MTOtherBCBS PROVIDER NUMBER
TX7694707OtherAETNA PROVIDER ID#
TX0159160655OtherPACIFICARE ENROLLMENT ID#
TX9391387OtherPHCS PCP ID#
TX8F1814Medicare PIN
TX0062MTOtherBCBS PROVIDER NUMBER