MEDICARE: THUY NGUYEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	36513	TX

General Provider Information

NPI Number	:	1497366835
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THUY NGUYEN

Provider Business Mailing Address
First Line	:	10152 BEEKMAN PLACE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77043-4314
Country	:	US
Telephone Number	:	346-971-0118
Fax Number	:

Provider Business Practice Location Address
First Line	:	12168 BELLAIRE BLVD STE 100
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77072-2642
Country	:	US
Telephone Number	:	281-400-1111
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2020
Last Update Date	:	08/10/2020

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Directions to “ THUY NGUYEN ” Practice Location

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