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Individual
LISA NGUYEN
Active
Individual
LISA NGUYEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA06372
TX
363AM0700X
Medical Physician Assistant
PA06372
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA06372
STATE LICENSE
TX
Enumeration date
12/07/2009
Last updated
08/30/2016
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