Provider Demographics
NPI:1932174711
Name:NGUYEN, HOWARD H (DO)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:H
Last Name:NGUYEN
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:PO BOX 630615
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-0130
Mailing Address - Country:US
Mailing Address - Phone:214-630-9559
Mailing Address - Fax:214-630-4992
Practice Address - Street 1:2261 SINGLETON BLVD
Practice Address - Street 2:#101
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75212-3733
Practice Address - Country:US
Practice Address - Phone:214-630-9559
Practice Address - Fax:214-630-4992
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-23
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0959207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1548405103OtherMEDICARE GROUP NPI
TX8F20486OtherMEDICARE INDIVIDUAL PTAN
TX121328204Medicaid
TX121328205Medicaid
TX0A3311OtherMEDICARE GROUP PTAN
TX1932174711OtherMEDICARE INDIVIDUAL NPI
TX752906860OtherTAX ID