Provider Demographics
NPI:1245727890
Name:NGUYEN, THANG PHUC (DO)
Entity type:Individual
Prefix:
First Name:THANG
Middle Name:PHUC
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 NORTH LOOP W STE 600
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-1094
Mailing Address - Country:US
Mailing Address - Phone:713-866-6201
Mailing Address - Fax:713-866-6202
Practice Address - Street 1:2525 NORTH LOOP W STE 600
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-1094
Practice Address - Country:US
Practice Address - Phone:713-866-6201
Practice Address - Fax:713-866-6202
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-19
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX390200000X
TXT5180207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty