Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | G 2455 | TX |
NPI | 1326196734 |
---|---|
Provider Name | Dr. Phung Dinh Nguyen |
First Address | Houston, TX 77006-3609 |
Second Address | Houston, TX 77006-3609 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C 19882 | (02) | TX |