Provider Demographics
NPI:1588013569
Name:NGUYEN, HUAN CANH
Entity Type:Individual
Prefix:
First Name:HUAN
Middle Name:CANH
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:891 KELLER PKWY STE 101
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-2486
Mailing Address - Country:US
Mailing Address - Phone:682-227-5912
Mailing Address - Fax:682-307-4300
Practice Address - Street 1:891 KELLER PKWY STE 101
Practice Address - Street 2:
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248-2486
Practice Address - Country:US
Practice Address - Phone:682-593-4273
Practice Address - Fax:682-307-4300
Is Sole Proprietor?:No
Enumeration Date:2016-06-09
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR46062083P0011X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric Medicine