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Individual

PHUONG T. NGUYEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6420 CLAYTON RD, 6TH FLOOR, SAINT LOUIS, MO 63117-1811
(314) 768-8205
(314) 768-5315
Mailing address
1776 WOODSTEAD CT STE 208, THE WOODLANDS, TX 77380-1480
(877) 749-7428
(281) 724-3100

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
R8G80
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
202403606
MO
01
250004623
RR MEDICARE
MO
Enumeration date
06/27/2006
Last updated
08/22/2019
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