Provider Demographics
NPI:1881941938
Name:NGUYEN, TIFFANY DUNG (NP)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:DUNG
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7001 CORPORATE DR STE 120
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-5113
Mailing Address - Country:US
Mailing Address - Phone:713-773-0803
Mailing Address - Fax:281-568-5414
Practice Address - Street 1:14438 BELLAIRE BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77083-7520
Practice Address - Country:US
Practice Address - Phone:281-568-5184
Practice Address - Fax:281-568-5414
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-08
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX768623363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily