Provider Demographics
NPI:1750374542
Name:NGUYEN, PAMELA PHUONG (MD)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:PHUONG
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:PAMELA
Other - Middle Name:PHUONG
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:190 HEIGHTS BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-3729
Mailing Address - Country:US
Mailing Address - Phone:713-529-3597
Mailing Address - Fax:713-529-9169
Practice Address - Street 1:190 HEIGHTS BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-3729
Practice Address - Country:US
Practice Address - Phone:713-529-3597
Practice Address - Fax:713-529-9169
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2013-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2502207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX080591302OtherTAMG GROUP THSTEPS NUMB
TX8J6546OtherTAMG MEDICARE INDIVIDUAL
TX187050301OtherTAMG INDIVIDUAL MEDICAID
TX187050301Medicaid
TX00438NOtherTAMG BCBS GROUP NUMBER
TX00438NOtherTAMG MEDICARE GROUP NUMBE
TX080591301OtherTAMG GROUP MEDICAID NUMBE
TX8H1985OtherTAMG BCBS INDIVIDUAL NUMB