Provider Demographics
NPI:1609936582
Name:NGUYEN, MARIA P (MD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:P
Last Name:NGUYEN
Suffix:
Gender:F
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:PO BOX 650859
Mailing Address - Street 2:DEPT 710
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75265
Mailing Address - Country:US
Mailing Address - Phone:409-772-2222
Mailing Address - Fax:
Practice Address - Street 1:2020 E HIGHWAY 6
Practice Address - Street 2:
Practice Address - City:ALVIN
Practice Address - State:TX
Practice Address - Zip Code:77511-8507
Practice Address - Country:US
Practice Address - Phone:281-585-2530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL1412208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX145177502Medicaid
TX760010407OtherEIN
TXH43155Medicare UPIN
TX00R518Medicare PIN
TX760010407OtherEIN
TX145177502Medicaid
TX370019284Medicare PIN
TXTXB112674Medicare PIN