Provider Demographics
NPI:1780199364
Name:NGUYEN, MICHELLE DAN VY
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:DAN VY
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5151 KATY FWY STE 202
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-2261
Mailing Address - Country:US
Mailing Address - Phone:713-485-4302
Mailing Address - Fax:
Practice Address - Street 1:5151 KATY FWY STE 202
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-2261
Practice Address - Country:US
Practice Address - Phone:713-485-4302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-05
Last Update Date:2022-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP134224363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty