Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | K3356 | TX |
NPI | 1003805813 |
---|---|
Provider Name | Dominique H Nguyen |
First Address | Dallas, TX 75284-0853 |
Second Address | Houston, TX 77042 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2005 |
Last Update Date | 27/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8K4721 | (02) | TX |
F96921 | (02) | TX |