Healthcare Provider Details
I. General information
NPI: 1215187836
Provider Name (Legal Business Name): THU C NGUYEN MD PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/19/2008
Last Update Date: 11/20/2024
Certification Date: 11/20/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
27230 HIGHWAY 290 DEPT 300
CYPRESS TX
77433-2214
US
IV. Provider business mailing address
27230 HIGHWAY 290 DEPT 300
CYPRESS TX
77433-2214
US
V. Phone/Fax
- Phone: 832-237-7777
- Fax: 713-456-3516
- Phone: 832-237-7777
- Fax: 713-456-3516
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Y00000X |
| Taxonomy | Otolaryngology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
CONG
THU
NGUYEN
Title or Position: OWNER
Credential: MD
Phone: 832-237-7777