Provider Demographics
NPI:1528004678
Name:NGUYEN, MINH CHINH (MD)
Entity Type:Individual
Prefix:
First Name:MINH
Middle Name:CHINH
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4401 COIT RD
Mailing Address - Street 2:STE 301
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-0500
Mailing Address - Country:US
Mailing Address - Phone:469-865-9530
Mailing Address - Fax:972-294-3418
Practice Address - Street 1:4401 COIT RD
Practice Address - Street 2:STE 301
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-0500
Practice Address - Country:US
Practice Address - Phone:469-865-9530
Practice Address - Fax:972-294-3418
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-20
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7826208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX168630501Medicaid
TX610314Medicare PIN
TXI02669Medicare UPIN
TX168630501Medicaid