MEDICARE: AMY NGUYEN NP

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	363L00000X	Nurse Practitioner	1113480	TX

General Provider Information

NPI Number	:	1780392233
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY NGUYEN NP

Provider Business Mailing Address
First Line	:	5119 POMEGRANATE PATH
Second Line	:
City	:	MANVEL
State	:	TX
Zip	:	77578-4073
Country	:	US
Telephone Number	:	832-757-8475
Fax Number	:

Provider Business Practice Location Address
First Line	:	6565 FANNIN ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2703
Country	:	US
Telephone Number	:	346-238-8100
Fax Number	:

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

Provider Enumeration Date	:	11/14/2022
Last Update Date	:	02/27/2026

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