Provider Demographics
NPI:1609310242
Name:NGUYEN, JASMINE-VY (PA-C)
Entity type:Individual
Prefix:
First Name:JASMINE-VY
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10868 KUYKENDAHL RD STE E
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77381-2873
Mailing Address - Country:US
Mailing Address - Phone:346-478-0831
Mailing Address - Fax:
Practice Address - Street 1:10868 KUYKENDAHL RD STE E
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77381-2873
Practice Address - Country:US
Practice Address - Phone:346-478-0831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-16
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV363A00000X
TXPA11992363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant