Provider Demographics
NPI:1902544059
Name:NGUYEN, LE DONG QUAN (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LE DONG QUAN
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:QUAN
Other - Middle Name:
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:288/D6 NAM KY KHOI NGHIA P. VO THI SAU, Q.3
Mailing Address - Street 2:
Mailing Address - City:HO CHI MINH CITY
Mailing Address - State:VIETNAM
Mailing Address - Zip Code:722700
Mailing Address - Country:VN
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6701 PINEMONT DR STE 200
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77092-3131
Practice Address - Country:US
Practice Address - Phone:832-209-7830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-26
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX119579235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist