Provider Demographics
NPI:1396393260
Name:NGUYEN, LAN NGOC
Entity Type:Individual
Prefix:MRS
First Name:LAN
Middle Name:NGOC
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24183 FORD RD APT 21
Mailing Address - Street 2:
Mailing Address - City:PORTER
Mailing Address - State:TX
Mailing Address - Zip Code:77365-9537
Mailing Address - Country:US
Mailing Address - Phone:832-420-0814
Mailing Address - Fax:
Practice Address - Street 1:24183 FORD RD APT 21
Practice Address - Street 2:
Practice Address - City:PORTER
Practice Address - State:TX
Practice Address - Zip Code:77365-9537
Practice Address - Country:US
Practice Address - Phone:832-420-0814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-03
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider