Provider Demographics
NPI:1265774582
Name:NGUYEN, HUNG (MD, ABSA, CNIM)
Entity type:Individual
Prefix:
First Name:HUNG
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:MD, ABSA, CNIM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12314 TAMBOURINE DR
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-1267
Mailing Address - Country:US
Mailing Address - Phone:832-540-3658
Mailing Address - Fax:281-564-9256
Practice Address - Street 1:6400 FANNIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1521
Practice Address - Country:US
Practice Address - Phone:713-791-9778
Practice Address - Fax:281-564-9256
Is Sole Proprietor?:No
Enumeration Date:2013-03-25
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX494246ZE0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic