Provider Demographics
NPI:1821260514
Name:NGUYEN, NHU NGUYEN T (MD)
Entity Type:Individual
Prefix:
First Name:NHU NGUYEN
Middle Name:T
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1626 MEDICAL CENTER DR STE 400
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-5000
Mailing Address - Country:US
Mailing Address - Phone:915-546-9200
Mailing Address - Fax:915-546-9800
Practice Address - Street 1:1626 MEDICAL CENTER DR STE 400
Practice Address - Street 2:4TH FLOOR
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-5000
Practice Address - Country:US
Practice Address - Phone:915-546-9200
Practice Address - Fax:915-546-9800
Is Sole Proprietor?:No
Enumeration Date:2008-04-02
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM8213207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX193016602Medicaid
TX193016601Medicaid
NM13774573Medicaid
TX193016603Medicaid
TX193016601Medicaid
NM13774573Medicaid