Provider Demographics
NPI:1487217444
Name:NGUYEN, THY M (DO)
Entity Type:Individual
Prefix:
First Name:THY
Middle Name:M
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:KRISLA
Other - Middle Name:THY
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:10624 S EASTERN AVE STE A
Mailing Address - Street 2:PMB 873
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-2983
Mailing Address - Country:US
Mailing Address - Phone:702-478-5111
Mailing Address - Fax:702-602-9012
Practice Address - Street 1:3039 W HORIZON RIDGE PKWY STE 110
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4193
Practice Address - Country:US
Practice Address - Phone:702-478-5111
Practice Address - Fax:702-602-9012
Is Sole Proprietor?:No
Enumeration Date:2019-04-16
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVDO3378207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology