Provider Demographics
NPI:1700190329
Name:DINH DUC NGUYEN
Entity Type:Organization
Organization Name:DINH DUC NGUYEN
Other - Org Name:DYNAMIC SPINE, REHABILITATION CENTER DBA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:DINH
Authorized Official - Middle Name:DUC
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:281-931-8899
Mailing Address - Street 1:PO BOX 721913
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77272-1913
Mailing Address - Country:US
Mailing Address - Phone:281-931-8899
Mailing Address - Fax:
Practice Address - Street 1:7419 S KIRKWOOD RD STE B
Practice Address - Street 2:SUITE B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77072-3350
Practice Address - Country:US
Practice Address - Phone:281-931-8899
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-06
Last Update Date:2014-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6241261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation