Provider Demographics
NPI:1659421535
Name:NGUYEN, THUAN TRONG (MD)
Entity Type:Individual
Prefix:DR
First Name:THUAN
Middle Name:TRONG
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 1:12060 BELLAIRE BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77072-2569
Mailing Address - Country:US
Mailing Address - Phone:281-983-0205
Mailing Address - Fax:281-983-0385
Practice Address - Street 1:12060 BELLAIRE BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77072-2569
Practice Address - Country:US
Practice Address - Phone:281-983-0205
Practice Address - Fax:281-983-0385
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ2237174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF78002Medicare UPIN
TX0068BAMedicare ID - Type Unspecified