Provider Demographics
NPI:1609253202
Name:NGUYEN, KIM PHUNG LE (MD)
Entity Type:Individual
Prefix:
First Name:KIM PHUNG
Middle Name:LE
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:23814 HIGHWAY 59 N
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-1510
Mailing Address - Country:US
Mailing Address - Phone:281-312-5558
Mailing Address - Fax:281-727-0827
Practice Address - Street 1:23814 HIGHWAY 59 N
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-1510
Practice Address - Country:US
Practice Address - Phone:281-312-5558
Practice Address - Fax:281-727-0827
Is Sole Proprietor?:No
Enumeration Date:2015-05-04
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXS6263207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology