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General NPI Number Information
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NPI Number | 1518631449
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Entity Type | Individual
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Provider Name | PHUC HOANG VU NGUYEN DDS
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Gender | Male
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Dates
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Enumeration Date | 08/04/2021
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Last Update Date | 09/08/2021
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Provider Practice Location Address
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Address Line | 11201 BELLAIRE BLVD STE A-18
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City | HOUSTON
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State | TX
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Zip | 77072-2566
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Country | US
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Telephone | 281-568-8200
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Fax |
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Provider Business Mailing Address
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Address Line | 2865 WESTHOLLOW DR UNIT 24
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City | HOUSTON
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State | TX
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Zip | 77082-3319
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Country | US
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Telephone | 832-382-0038
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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 | 37686
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 37686
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License Number State | TX
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