Provider Demographics
NPI:1851610901
Name:NGUYEN, TRAM DOAN (DDS)
Entity Type:Individual
Prefix:
First Name:TRAM
Middle Name:DOAN
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3718 BLUSHING HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-5990
Mailing Address - Country:US
Mailing Address - Phone:225-993-1225
Mailing Address - Fax:
Practice Address - Street 1:4519 HIGHWAY 6 N
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-3401
Practice Address - Country:US
Practice Address - Phone:225-993-1225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-27
Last Update Date:2020-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6054122300000X
TX29542122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist