Provider Demographics
NPI:1477014967
Name:NGUYEN, DANIEL
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:819 PEAKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-2905
Mailing Address - Country:US
Mailing Address - Phone:281-645-5013
Mailing Address - Fax:713-903-7958
Practice Address - Street 1:819 PEAKWOOD DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2905
Practice Address - Country:US
Practice Address - Phone:281-645-5013
Practice Address - Fax:713-903-7958
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-27
Last Update Date:2023-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS9946207ND0101X, 207N00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic SurgeryGroup - Multi-Specialty
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty