Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | L0453 | TX |
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | L0453 | TX |
NPI | 1699747410 |
---|---|
Provider Name | Dr. Cong Thu Nguyen |
First Address | Cypress, TX 77433-2214 |
Second Address | Houston, TX 77065-3827 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2006 |
Last Update Date | 06/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H28956 | (02) | TX |
P000515M3 | (05) | TX |