Provider Demographics
NPI:1407192883
Name:NGUYEN, THAI V (DO)
Entity Type:Individual
Prefix:
First Name:THAI
Middle Name:V
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 NORTH LOOP E # 100
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77022-5934
Mailing Address - Country:US
Mailing Address - Phone:832-380-2580
Mailing Address - Fax:832-380-2583
Practice Address - Street 1:6565 WEST LOOP S STE 525
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-3519
Practice Address - Country:US
Practice Address - Phone:713-661-7888
Practice Address - Fax:713-661-7899
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-12
Last Update Date:2023-08-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXP9923207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX376220ZH8ROtherMEDICARE PROVIDER NUMBER