Provider Demographics
NPI:1619778644
Name:NGUYEN, THIEN PETER (DPT, PT)
Entity type:Individual
Prefix:
First Name:THIEN
Middle Name:PETER
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3824 S CARRIER PKWY STE 490
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-6668
Mailing Address - Country:US
Mailing Address - Phone:817-561-1115
Mailing Address - Fax:817-516-1104
Practice Address - Street 1:5833 W I 20
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-1057
Practice Address - Country:US
Practice Address - Phone:817-561-1115
Practice Address - Fax:817-516-1104
Is Sole Proprietor?:No
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPENDING225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist