Healthcare Provider Details

I. General information

NPI: 1548757768
Provider Name (Legal Business Name): DIANA NGUYEN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2018
Last Update Date: 05/02/2025
Certification Date: 05/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6930 PARKWOOD BLVD
FRISCO TX
75034-7441
US

IV. Provider business mailing address

PO BOX 733784
DALLAS TX
75373-3784
US

V. Phone/Fax

Practice location:
  • Phone: 945-204-7940
  • Fax: 945-204-7941
Mailing address:
  • Phone: 682-885-6483
  • Fax: 682-303-7132

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberT0583
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: