Provider Demographics
NPI:1255121570
Name:HUYNH, MY TAN (NDTR, RDN, LDN)
Entity type:Individual
Prefix:MR
First Name:MY
Middle Name:TAN
Last Name:HUYNH
Suffix:
Gender:
Credentials:NDTR, RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1333 OLD SPANISH TRL APT 4133
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-1870
Mailing Address - Country:US
Mailing Address - Phone:626-215-4310
Mailing Address - Fax:
Practice Address - Street 1:1333 OLD SPANISH TRL APT 4133
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1870
Practice Address - Country:US
Practice Address - Phone:626-215-4310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-09
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT89944133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered