Provider Demographics
NPI:1710578190
Name:NGUYEN, LAURA TU ANH (MPAS, PA-C)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:TU ANH
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MPAS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15918 EMERALD BRIAR LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-6856
Mailing Address - Country:US
Mailing Address - Phone:832-858-9514
Mailing Address - Fax:
Practice Address - Street 1:17510 W GRAND PKWY S STE 420
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-2173
Practice Address - Country:US
Practice Address - Phone:832-308-3470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-28
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA14290363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical