Individual
DIANE NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5323 HARRY HINES BLVD, DALLAS, TX 75390-9257
(214) 648-3111
Mailing address
PO BOX 845347, DALLAS, TX 75284-7208
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301096060
MI
207RG0100X
Gastroenterology Physician
4301096060
MI
207RG0100X
Gastroenterology Physician
Primary
Q3068
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
346359801
—
TX
01
—
415654YL7A
MEDICARE - OTHER
TX
01
—
415654YL7B
MEDICARE - DALLAS
TX
01
—
415654YNGS
MEDICARE - TARRANT
TX
Enumeration date
07/23/2007
Last updated
02/14/2019
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