Provider Demographics
NPI:1427032994
Name:NGUYEN, TUYET T (DDS)
Entity Type:Individual
Prefix:
First Name:TUYET
Middle Name:T
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3111 S. TEXAS AVE.
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77802-3159
Mailing Address - Country:US
Mailing Address - Phone:979-446-0270
Mailing Address - Fax:979-775-7641
Practice Address - Street 1:3111 S. TEXAS AVE.
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-3159
Practice Address - Country:US
Practice Address - Phone:979-446-0270
Practice Address - Fax:979-775-7641
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2008-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX205071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX20507OtherTX STATE BOARD/DENTAL