MEDICARE: NGUYET ANH NGUYEN MMS, PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor
2	363A00000X	Physician Assistant	PA07542	TX

General Provider Information

NPI Number	:	1033301056
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NGUYET ANH NGUYEN MMS, PA-C

Provider Business Mailing Address
First Line	:	15 EVENING SONG CT
Second Line	:
City	:	THE WOODLANDS
State	:	TX
Zip	:	77380-4218
Country	:	US
Telephone Number	:	504-251-0804
Fax Number	:

Provider Business Practice Location Address
First Line	:	314 SAWDUST RD
Second Line	:	119
City	:	THE WOODLANDS
State	:	TX
Zip	:	77380-2347
Country	:	US
Telephone Number	:	281-292-3030
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/14/2007
Last Update Date	:	03/20/2026

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