Healthcare Provider Details

I. General information

NPI: 1649131657
Provider Name (Legal Business Name): NICOLE VUONG DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/19/2025
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 N MACARTHUR BLVD STE 111
IRVING TX
75038-6400
US

IV. Provider business mailing address

4326 EMERSON DR
GRAND PRAIRIE TX
75052-4002
US

V. Phone/Fax

Practice location:
  • Phone: 469-565-2354
  • Fax: 877-301-3534
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number16599
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: