Provider Demographics
NPI:1457462954
Name:HUYNH, NGUYEN P (DO)
Entity Type:Individual
Prefix:DR
First Name:NGUYEN
Middle Name:P
Last Name:HUYNH
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 1:1101 ALMA ST STE 102
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-4559
Mailing Address - Country:US
Mailing Address - Phone:832-843-7075
Mailing Address - Fax:832-843-7157
Practice Address - Street 1:1101 ALMA ST STE 102
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-4559
Practice Address - Country:US
Practice Address - Phone:832-843-7075
Practice Address - Fax:832-843-7157
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ0460207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX349232406Medicaid
MS00884537Medicaid
MS110001926Medicare ID - Type Unspecified
MS00884537Medicaid