Provider Demographics
NPI:1518472646
Name:NGUYEN, CANH-LIEN (RD LD)
Entity type:Individual
Prefix:
First Name:CANH-LIEN
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:RD LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5900 BALCONES DR STE 10069
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4257
Mailing Address - Country:US
Mailing Address - Phone:713-588-6222
Mailing Address - Fax:855-731-1379
Practice Address - Street 1:5900 BALCONES DR STE 10069
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-4257
Practice Address - Country:US
Practice Address - Phone:713-588-6222
Practice Address - Fax:855-731-1379
Is Sole Proprietor?:No
Enumeration Date:2017-12-12
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT80837133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered