Provider Demographics
NPI:1548608599
Name:NGUYEN, KHANG DUY (MD)
Entity Type:Individual
Prefix:
First Name:KHANG
Middle Name:DUY
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 1:5323 HARRY HINES BLVD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75390-9069
Mailing Address - Country:US
Mailing Address - Phone:214-645-2400
Mailing Address - Fax:214-645-2405
Practice Address - Street 1:5323 HARRY HINES BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-9069
Practice Address - Country:US
Practice Address - Phone:214-645-2400
Practice Address - Fax:214-645-2405
Is Sole Proprietor?:No
Enumeration Date:2013-06-12
Last Update Date:2018-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR2932207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology