Healthcare Provider Details

I. General information

NPI: 1619130929
Provider Name (Legal Business Name): CLAUDE BERNARD NGUYEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2008
Last Update Date: 09/19/2024
Certification Date: 09/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10905 MEMORIAL HERMANN DR STE 111
PEARLAND TX
77584-3490
US

IV. Provider business mailing address

10905 MEMORIAL HERMANN DR STE 111
PEARLAND TX
77584-3490
US

V. Phone/Fax

Practice location:
  • Phone: 281-929-4727
  • Fax: 281-929-4728
Mailing address:
  • Phone: 281-929-4727
  • Fax: 281-929-4728

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License NumberP3655
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberP3655
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: