Provider Demographics
NPI:1710760863
Name:NGUYEN, ANTHONY KHANH (DC)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:KHANH
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4400 MEMORIAL DRIVE APT 1054
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007
Mailing Address - Country:US
Mailing Address - Phone:913-203-5673
Mailing Address - Fax:
Practice Address - Street 1:9595 SIX PINES DR STE 1480
Practice Address - Street 2:
Practice Address - City:WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380
Practice Address - Country:US
Practice Address - Phone:281-336-8546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15237111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor