Provider Demographics
NPI:1457330029
Name:NGUYEN, TUAN HOANG (MD)
Entity Type:Individual
Prefix:
First Name:TUAN
Middle Name:HOANG
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 1:12060 BELLAIRE BLVD
Mailing Address - Street 2:SUITE D
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77072-2569
Mailing Address - Country:US
Mailing Address - Phone:281-933-7900
Mailing Address - Fax:281-933-7999
Practice Address - Street 1:12060 BELLAIRE BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77072-2569
Practice Address - Country:US
Practice Address - Phone:281-933-7900
Practice Address - Fax:281-933-7999
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2011-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0961208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX092376501Medicaid
TXG42413Medicare UPIN
00985JMedicare ID - Type Unspecified