Provider Demographics
NPI:1447281829
Name:NGUYEN, HAC HONG (MD)
Entity type:Individual
Prefix:DR
First Name:HAC
Middle Name:HONG
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16736 CHAMPION FOREST DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-7024
Mailing Address - Country:US
Mailing Address - Phone:832-816-6781
Mailing Address - Fax:281-320-8143
Practice Address - Street 1:16736 CHAMPION FOREST DR
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-7024
Practice Address - Country:US
Practice Address - Phone:832-816-6781
Practice Address - Fax:281-320-8143
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8691207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP084261J0Medicaid
TXG62762Medicare UPIN
TXP084261J0Medicaid