Healthcare Provider Details

I. General information

NPI: 1699747410
Provider Name (Legal Business Name): CONG THU NGUYEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: CT NGUYEN M.D.

II. Dates (important events)

Enumeration Date: 02/06/2006
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

Practice location:
  • Phone: 832-237-7777
  • Fax: 713-456-3516
Mailing address:
  • Phone: 832-237-7777
  • Fax: 713-456-3516

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License NumberL0453
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: