Provider Demographics
NPI:1609415660
Name:NGUYEN, NAM
Entity Type:Individual
Prefix:
First Name:NAM
Middle Name:
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 1:8277 BELLEVIEW DR STE 275
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-0358
Mailing Address - Country:US
Mailing Address - Phone:469-365-2225
Mailing Address - Fax:469-361-8265
Practice Address - Street 1:8277 BELLEVIEW DR STE 275
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-0358
Practice Address - Country:US
Practice Address - Phone:469-365-2225
Practice Address - Fax:469-361-8265
Is Sole Proprietor?:No
Enumeration Date:2019-12-23
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP144439363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAP144439OtherAPRN