Provider Demographics
NPI:1942060165
Name:NGUYEN, JOHNNY QUOC (MD)
Entity Type:Individual
Prefix:
First Name:JOHNNY
Middle Name:QUOC
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2902 HAINE DR
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8969
Mailing Address - Country:US
Mailing Address - Phone:956-296-4000
Mailing Address - Fax:956-296-2842
Practice Address - Street 1:2902 HAINE DR
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8969
Practice Address - Country:US
Practice Address - Phone:956-296-4000
Practice Address - Fax:956-296-2842
Is Sole Proprietor?:No
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program