Provider Demographics
NPI:1376567156
Name:NGUYEN, TRANG H (DPM)
Entity type:Individual
Prefix:DR
First Name:TRANG
Middle Name:H
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2102 VERONA DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-4762
Mailing Address - Country:US
Mailing Address - Phone:713-851-9438
Mailing Address - Fax:713-923-2292
Practice Address - Street 1:9896 BELLAIRE BLVD STE H
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-3496
Practice Address - Country:US
Practice Address - Phone:713-851-9438
Practice Address - Fax:713-923-2292
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1443213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX080803201Medicaid
TX680552086OtherTAX ID
TX0053KDOtherBLUE CROSS AND BLUE SHIEL
TX080803201Medicaid
TXU71174Medicare UPIN
TX4332050001Medicare NSC