Individual
LUCI THAO NGUYEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
115 MEDICAL DR, SUITE 104, VICTORIA, TX 77904-3102
(361) 578-7703
Mailing address
115 MEDICAL DR, SUITE 104, VICTORIA, TX 77904-3102
(361) 578-7703
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
K3358
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
029727701
—
TX
Enumeration date
02/06/2007
Last updated
06/23/2010
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