Provider Demographics
NPI:1881718997
Name:NGUYEN PHUC, HAP V (DDS)
Entity type:Individual
Prefix:DR
First Name:HAP
Middle Name:V
Last Name:NGUYEN PHUC
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4601 N. LAMAR BLVD
Mailing Address - Street 2:SUITE# 503
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78751-2355
Mailing Address - Country:US
Mailing Address - Phone:512-454-0300
Mailing Address - Fax:
Practice Address - Street 1:4601 N. LAMAR BLVD
Practice Address - Street 2:SUITE# 503
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78751-2355
Practice Address - Country:US
Practice Address - Phone:512-454-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX226941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice