Provider Demographics
NPI:1174531560
Name:NGUYEN, HA THI-BICH (DO)
Entity type:Individual
Prefix:
First Name:HA
Middle Name:THI-BICH
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 FROSTWOOD DR
Mailing Address - Street 2:SUITE 1.100
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2301
Mailing Address - Country:US
Mailing Address - Phone:713-338-5519
Mailing Address - Fax:
Practice Address - Street 1:4500 WASHINGTON AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-5476
Practice Address - Country:US
Practice Address - Phone:713-861-6490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A 9444207R00000X
TXK3929207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX045397902Medicaid
TXG90772Medicare UPIN
TX8B1893Medicare ID - Type Unspecified