Provider Demographics
NPI:1710039243
Name:NGUYEN, LYNN TRUC (OTR)
Entity Type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:TRUC
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2524 KINGSTON ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77019-6606
Mailing Address - Country:US
Mailing Address - Phone:281-221-8018
Mailing Address - Fax:713-522-9399
Practice Address - Street 1:2713 FERNDALE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-1113
Practice Address - Country:US
Practice Address - Phone:281-221-8018
Practice Address - Fax:713-522-9399
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100456225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist