Provider Demographics
NPI:1881037125
Name:NGUYEN, CHRISTINA LOC (DO)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:LOC
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10900 FOUNDERS WAY STE 101
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-4953
Mailing Address - Country:US
Mailing Address - Phone:817-442-9300
Mailing Address - Fax:817-416-0108
Practice Address - Street 1:10900 FOUNDERS WAY STE 101
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-4953
Practice Address - Country:US
Practice Address - Phone:817-442-9300
Practice Address - Fax:817-416-0108
Is Sole Proprietor?:No
Enumeration Date:2013-04-16
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ007199208100000X
TXR6060208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation