=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962438333
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | THUY-VAN THI NGUYEN NP-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/25/2006
-----------------------------------------------------
Last Update Date | 10/24/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11417 VETERANS MEMORIAL DRIVE
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77067
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-955-3919
-----------------------------------------------------
Fax | 713-673-8016
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11417 VETERANS MEMORIAL DR
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77067-2601
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-955-3919
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | AP125304
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------