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General NPI Number Information
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NPI Number | 1104041250
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Entity Type | Individual
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Provider Name | LAN T NGUYEN D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 04/16/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1205 CLEAR LAKE CITY BLVD
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City | HOUSTON
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State | TX
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Zip | 77062-8105
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Country | US
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Telephone | 281-488-1477
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Fax | 281-286-2149
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Provider Business Mailing Address
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Address Line | 2105 WOODS CT
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City | PEARLAND
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State | TX
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Zip | 77581-5198
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Country | US
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Telephone | 281-922-0330
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 17157
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License Number State | TX
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