Provider Demographics
NPI:1447362488
Name:NGUYEN, THUY NGOC (MD)
Entity type:Individual
Prefix:DR
First Name:THUY
Middle Name:NGOC
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3555 W WALNUT ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042-4017
Mailing Address - Country:US
Mailing Address - Phone:972-276-8688
Mailing Address - Fax:972-276-4473
Practice Address - Street 1:3555 W WALNUT ST
Practice Address - Street 2:SUITE A
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-4017
Practice Address - Country:US
Practice Address - Phone:972-276-8688
Practice Address - Fax:972-276-4473
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ7285207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX030585601Medicaid
TX89724ZOtherBCBS
TX89724ZOtherBCBS
TX0054APMedicare PIN