Provider Demographics
NPI:1679706824
Name:NGUYEN-DEEBOOCKUM, DUYEN THI (DC)
Entity Type:Individual
Prefix:DR
First Name:DUYEN
Middle Name:THI
Last Name:NGUYEN-DEEBOOCKUM
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1718 FRY RD STE 445
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-5843
Mailing Address - Country:US
Mailing Address - Phone:281-492-0190
Mailing Address - Fax:281-647-7706
Practice Address - Street 1:1718 FRY RD STE 445A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-5832
Practice Address - Country:US
Practice Address - Phone:281-492-0190
Practice Address - Fax:281-647-7706
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-03
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11243111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB146415Medicare PIN
TX375693ZRWMMedicare PIN
TX375693Medicare PIN