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Individual

KYQUANG BA NGUYEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
AA

Contact information

Practice address
1500 CITYWEST BLVD, STE. 300, HOUSTON, TX 77042-2300
(713) 620-4000
(713) 458-4229
Mailing address
PO BOX 650865, DALLAS, TX 75265-0865
(972) 233-1999
(972) 233-3666

Taxonomy

Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
1150
NC
367H00000X
Anesthesiologist Assistant
Primary
1150
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
345674101
TX
01
P01010718
RR MEDICARE
TX
Enumeration date
10/04/2010
Last updated
08/13/2020
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