{
"Npi": {
"NPI": "1861491847",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "NGUYEN",
"FirstName": "NICK",
"MiddleName": null,
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "DC, NP-C",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "NGUYEN",
"OtherFirstName": "NICK",
"OtherMiddleName": "CONG",
"OtherNamePrefix": "DR.",
"OtherNameSuffix": null,
"OtherCredential": "DC, NP-C",
"OtherLastNameTypeCode": "5",
"FirstLineMailingAddress": "2700 SANDCREST DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MANVEL",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "77578-3245",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "850 CENTRAL PKWY E STE 275",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PLANO",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "75074-5542",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "972-881-4688",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/20/2005",
"LastUpdateDate": "07/03/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "363L00000X",
"TaxonomyName": "Nurse Practitioner",
"LicenseNumber": "777198",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363LF0000X",
"TaxonomyName": "Family Nurse Practitioner",
"LicenseNumber": "777198",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}