Healthcare Provider Details

I. General information

NPI: 1275534976
Provider Name (Legal Business Name): ANH THI NGUYEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2005
Last Update Date: 10/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 PECAN GORGE CT
SUGAR LAND TX
77479-5935
US

IV. Provider business mailing address

5 PECAN GORGE CT
SUGAR LAND TX
77479-5935
US

V. Phone/Fax

Practice location:
  • Phone: 832-741-6105
  • Fax: 281-313-1194
Mailing address:
  • Phone: 832-741-6105
  • Fax: 281-313-1194

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberH4842
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: