Provider Demographics
NPI:1730254731
Name:NGUYEN, THU NGUYET (DDS)
Entity type:Individual
Prefix:MS
First Name:THU NGUYET
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14360 BELLAIRE BOULEVARD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083
Mailing Address - Country:US
Mailing Address - Phone:281-575-8008
Mailing Address - Fax:281-575-8008
Practice Address - Street 1:14360 BELLAIRE BOULEVARD
Practice Address - Street 2:SUITE 104
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77083
Practice Address - Country:US
Practice Address - Phone:281-575-8008
Practice Address - Fax:281-575-8008
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16931122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX111102301Medicaid