Provider Demographics
NPI:1316745417
Name:NGUYEN, WAYNE (PSYD)
Entity type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:
Credentials:PSYD
Other - Prefix:DR
Other - First Name:BOBBY
Other - Middle Name:
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD
Mailing Address - Street 1:10100 ALCOTT CV
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-1221
Mailing Address - Country:US
Mailing Address - Phone:425-772-7364
Mailing Address - Fax:
Practice Address - Street 1:3006 BEE CAVES RD STE D300
Practice Address - Street 2:
Practice Address - City:ROLLINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:78746-6735
Practice Address - Country:US
Practice Address - Phone:512-537-6515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39740103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical