Provider Demographics
NPI:1609967165
Name:NGUYEN, THIEU VINH (MD)
Entity Type:Individual
Prefix:DR
First Name:THIEU
Middle Name:VINH
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 1:7500 BEECHNUT ST STE 291
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-4336
Mailing Address - Country:US
Mailing Address - Phone:713-272-9022
Mailing Address - Fax:713-272-8707
Practice Address - Street 1:7500 BEECHNUT ST STE 291
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-4336
Practice Address - Country:US
Practice Address - Phone:713-272-9022
Practice Address - Fax:713-272-8707
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ2236174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F1230OtherBLUE CROSS BLUE SHIELD
TXG80528Medicare UPIN
TX33950RMedicare ID - Type Unspecified
TX8957N0Medicare ID - Type UnspecifiedPERSONAL ID