Provider Demographics
NPI:1962486878
Name:NGUYEN, PHUONG-DUNG JULIE (MD)
Entity Type:Individual
Prefix:
First Name:PHUONG-DUNG
Middle Name:JULIE
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:P JULIE
Other - Middle Name:
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:P. O. BOX 4346 DEPT # 114
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77210-4346
Mailing Address - Country:US
Mailing Address - Phone:713-979-1190
Mailing Address - Fax:713-979-1197
Practice Address - Street 1:6560 FANNIN STREET
Practice Address - Street 2:SUITE #1228
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030
Practice Address - Country:US
Practice Address - Phone:713-979-1190
Practice Address - Fax:713-979-1197
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH8290207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX135626311Medicaid
TXP00328597OtherRAILROAD MEDICARE INDIV #
8D1263Medicare PIN