Individual
DR. PHUC THANH NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
265 SE JOHN JONES DR STE 102, BURLESON, TX 76028-8356
(817) 877-5858
Mailing address
1000 W CANNON ST, FORT WORTH, TX 76104-3029
(817) 877-5858
(817) 335-4418
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2021-03447
NC
207R00000X
Internal Medicine Physician
M0841
TX
207RN0300X
Nephrology Physician
Primary
M0841
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
188082505
—
TX
Enumeration date
09/07/2006
Last updated
04/28/2026
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