Provider Demographics
NPI:1245704170
Name:NGUYEN, MICHAEL NHON
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:NHON
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 SHORE DISTRICT DR APT 2428
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78741-1335
Mailing Address - Country:US
Mailing Address - Phone:512-770-6293
Mailing Address - Fax:888-473-9584
Practice Address - Street 1:1330 SHORE DISTRICT DR APT 2428
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78741-1335
Practice Address - Country:US
Practice Address - Phone:512-770-6293
Practice Address - Fax:888-473-9584
Is Sole Proprietor?:No
Enumeration Date:2019-01-14
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist