Provider Demographics
NPI:1750993762
Name:NGUYEN, TIFFANY THAO
Entity type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:THAO
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20331 LITTLE WING DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77388-2579
Mailing Address - Country:US
Mailing Address - Phone:832-273-3716
Mailing Address - Fax:
Practice Address - Street 1:20331 LITTLE WING DR
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77388-2579
Practice Address - Country:US
Practice Address - Phone:832-273-3716
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-20
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1334584225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist