Provider Demographics
NPI:1639675564
Name:HUYNH, MY THI NGOC (APN)
Entity Type:Individual
Prefix:
First Name:MY
Middle Name:THI NGOC
Last Name:HUYNH
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11818 NEWPORT SHORE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-3991
Mailing Address - Country:US
Mailing Address - Phone:832-713-1993
Mailing Address - Fax:
Practice Address - Street 1:10680 JONES RD STE 1000
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-5702
Practice Address - Country:US
Practice Address - Phone:832-204-4984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-31
Last Update Date:2018-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP137118363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily