Healthcare Provider Details

I. General information

NPI: 1124379912
Provider Name (Legal Business Name): NHUYEN DANG NGUYEN DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2012
Last Update Date: 09/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4828 COLUMBIA AVE SUITE # 200
DALLAS TX
75226-1011
US

IV. Provider business mailing address

8911 SORRENTO ST
DALLAS TX
75228-4449
US

V. Phone/Fax

Practice location:
  • Phone: 214-826-9567
  • Fax:
Mailing address:
  • Phone: 214-901-0666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number12120
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: