Provider Demographics
NPI:1811196777
Name:DOAN, MINH LUAN NGUYEN (MD)
Entity Type:Individual
Prefix:DR
First Name:MINH LUAN
Middle Name:NGUYEN
Last Name:DOAN
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:3551 ROGER BROOKE DR DEPT OF
Mailing Address - Street 2:
Mailing Address - City:FORT SAM HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:78234-4504
Mailing Address - Country:US
Mailing Address - Phone:210-916-6551
Mailing Address - Fax:210-539-0302
Practice Address - Street 1:3551 ROGER BROOKE DR
Practice Address - Street 2:DEPARTMENT OF PEDIATRICS, BROOKE ARMY MEDICAL CENTER
Practice Address - City:JBSA FORT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-4501
Practice Address - Country:US
Practice Address - Phone:210-916-6624
Practice Address - Fax:210-539-0302
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL22252080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD000Medicare UPIN