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General NPI Number Information
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NPI Number | 1386819498
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Entity Type | Organization
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Legal Business Name | DIANE NGUYEN DO PLLC
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Dates
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Enumeration Date | 04/29/2008
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Last Update Date | 04/24/2017
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Provider Practice Location Address
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Address Line | 1010 RANCH ROAD 620 S STE 108
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City | LAKEWAY
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State | TX
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Zip | 78734-5636
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Country | US
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Telephone | 512-502-4556
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Fax | 512-263-9975
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Provider Business Mailing Address
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Address Line | 1010 RANCH ROAD 620 S STE 108
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City | LAKEWAY
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State | TX
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Zip | 78734-5636
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Country | US
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Telephone | 512-502-4556
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Fax | 512-263-9975
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DIANE PHUONG NGUYEN
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Credential | D.O.
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Telephone | 512-502-4556
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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