Provider Demographics
NPI:1508963919
Name:NONG, MARILYN PHUONG (MT (ASCP, NCA))
Entity Type:Individual
Prefix:
First Name:MARILYN
Middle Name:PHUONG
Last Name:NONG
Suffix:
Gender:F
Credentials:MT (ASCP, NCA)
Other - Prefix:
Other - First Name:PHUONG
Other - Middle Name:MINH
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MT (ASCP, NCA)
Mailing Address - Street 1:3352 BEACON VIEW CT
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7932
Mailing Address - Country:US
Mailing Address - Phone:713-794-7335
Mailing Address - Fax:
Practice Address - Street 1:3352 BEACON VIEW CT
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-7932
Practice Address - Country:US
Practice Address - Phone:713-794-7335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXASCP246QM0706X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QM0706XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyMedical Technologist