Provider Demographics
NPI:1497861975
Name:NGUYEN, MATTIE (DC)
Entity Type:Individual
Prefix:
First Name:MATTIE
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6633 HILLCROFT ST
Mailing Address - Street 2:SUITE 109
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081-4887
Mailing Address - Country:US
Mailing Address - Phone:713-776-0185
Mailing Address - Fax:713-550-1409
Practice Address - Street 1:6633 HILLCROFT ST
Practice Address - Street 2:SUITE 109
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-4887
Practice Address - Country:US
Practice Address - Phone:713-776-0185
Practice Address - Fax:713-550-1409
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7875111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor