Provider Demographics
NPI:1891083747
Name:NGUYEN, JENNIFER THY (DC)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:THY
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14780 MEMORIAL DR STE 113
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-5284
Mailing Address - Country:US
Mailing Address - Phone:281-809-6144
Mailing Address - Fax:281-940-2129
Practice Address - Street 1:14780 MEMORIAL DR STE 113
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-5284
Practice Address - Country:US
Practice Address - Phone:281-809-6144
Practice Address - Fax:281-940-2129
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-13
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11778111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor