Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223P0221X | Pediatric Dentist | 10197 | CT |
Y | 1223P0221X | Pediatric Dentist | 25265 | TX |
NPI | 1083937387 |
---|---|
Provider Name | Isabella Tran Nguyen |
First Address | Houston, TX 77005-3207 |
Second Address | Houston, TX 77096-1617 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/03/2010 |
Last Update Date | 01/09/2021 |