Healthcare Provider Details

I. General information

NPI: 1154802098
Provider Name (Legal Business Name): DIANA T NGUYEN PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2018
Last Update Date: 06/20/2024
Certification Date: 06/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SOUTH 2101 GREENHOUSE RD.
HOUSTON TX
77084
US

IV. Provider business mailing address

SOUTH 2101 GREENHOUSE RD.
HOUSTON TX
77084
US

V. Phone/Fax

Practice location:
  • Phone: 815-599-5540
  • Fax:
Mailing address:
  • Phone: 281-599-5540
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number2122436
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1385497
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: