Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 35750 | TX |
NPI | 1063057792 |
---|---|
Provider Name | Teresa Nguyen |
First Address | Houston, TX 77059-3261 |
Second Address | Pearland, TX 77581-5379 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2019 |
Last Update Date | 11/01/2022 |