Provider Demographics
NPI:1982063558
Name:NGUYEN, NGAN KIM (DC)
Entity Type:Individual
Prefix:DR
First Name:NGAN
Middle Name:KIM
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11615 SPRING CYPRESS RD
Mailing Address - Street 2:STE F
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77377-8920
Mailing Address - Country:US
Mailing Address - Phone:832-698-1656
Mailing Address - Fax:832-698-1473
Practice Address - Street 1:11615 SPRING CYPRESS RD
Practice Address - Street 2:STE F
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77377-8920
Practice Address - Country:US
Practice Address - Phone:832-698-1656
Practice Address - Fax:832-698-1473
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-11
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13040111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor