Provider Demographics
NPI:1679929319
Name:NGUYEN-REYES, TRACY NGOC-DUNG (MD)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:NGOC-DUNG
Last Name:NGUYEN-REYES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9500 LAKEVIEW PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75088-4560
Mailing Address - Country:US
Mailing Address - Phone:469-233-4880
Mailing Address - Fax:
Practice Address - Street 1:9500 LAKEVIEW PKWY STE 100
Practice Address - Street 2:
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75088-4560
Practice Address - Country:US
Practice Address - Phone:972-520-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-12
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXS5451207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program