Individual
NGOC DIEP THI NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPAS, PA-C
Contact information
Practice address
3901 TREEMONT CIR, COLLEYVILLE, TX 76034
(972) 975-0079
Mailing address
1919 HOPE WAY, DALLAS, TX 75206-8177
(972) 975-0079
(972) 863-9911
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA0445
TEXAS MEDICAL LICENSE
TX
Enumeration date
06/30/2006
Last updated
08/20/2018
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