Provider Demographics
NPI:1659703643
Name:HAP V. NGUYEN PHUC DDS PA
Entity Type:Organization
Organization Name:HAP V. NGUYEN PHUC DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HAP
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN PHUC
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:512-454-0300
Mailing Address - Street 1:4601 N LAMAR BLVD
Mailing Address - Street 2:SUITE# 503
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78751-2325
Mailing Address - Country:US
Mailing Address - Phone:512-454-0300
Mailing Address - Fax:512-454-0303
Practice Address - Street 1:4601 N LAMAR BLVD
Practice Address - Street 2:SUITE# 503
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78751-2325
Practice Address - Country:US
Practice Address - Phone:512-454-0300
Practice Address - Fax:512-454-0303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-01
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty