Individual
ELIZABETH TIEN NGUYEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3121 UNIVERSITY DR E STE 100, BRYAN, TX 77802-3499
(799) 776-0169
(799) 776-1342
Mailing address
8441 STATE HWY 47, STE 3115, BRYAN, TX 77807
(979) 436-9703
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
T9197
TX
208000000X
Pediatrics Physician
ME144828
FL
208000000X
Pediatrics Physician
T9197
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105940200
—
FL
01
—
2J4411
MEDICARE PTAN
TX
Enumeration date
06/19/2017
Last updated
10/21/2025
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