Provider Demographics
NPI:1366537243
Name:NEVLE, DAWN PHUONG (MD)
Entity type:Individual
Prefix:DR
First Name:DAWN
Middle Name:PHUONG
Last Name:NEVLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:20423 KUYKENDAHL RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-3492
Mailing Address - Country:US
Mailing Address - Phone:281-500-8660
Mailing Address - Fax:281-500-8669
Practice Address - Street 1:20423 KUYKENDAHL RD STE 100
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-3492
Practice Address - Country:US
Practice Address - Phone:281-500-8660
Practice Address - Fax:281-500-8669
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6625207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX110184123OtherRAILROAD MEDICARE
TX137965304Medicaid
TX45D0930092OtherCLIA
TXTXB135624OtherMEDICARE IND PTAN
TX0095AYMedicare ID - Type Unspecified
TX110184123OtherRAILROAD MEDICARE