Provider Demographics
NPI:1457854937
Name:NGUYEN, VICTORIA (SLPA)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:531 HAWTHORNE DR
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:TX
Mailing Address - Zip Code:75094-3545
Mailing Address - Country:US
Mailing Address - Phone:469-867-6023
Mailing Address - Fax:
Practice Address - Street 1:1201 N WATSON RD STE 220
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76006-6120
Practice Address - Country:US
Practice Address - Phone:817-422-9203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-12
Last Update Date:2018-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37767246Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Q00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Pathology