Provider Demographics
NPI:1346395613
Name:NGUYEN, DIANE PHUONG (MD)
Entity type:Individual
Prefix:DR
First Name:DIANE
Middle Name:PHUONG
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1010 RANCH RD. 630 S
Mailing Address - Street 2:SUITE 108
Mailing Address - City:LAKEWAY
Mailing Address - State:TX
Mailing Address - Zip Code:78738
Mailing Address - Country:US
Mailing Address - Phone:512-502-4556
Mailing Address - Fax:512-263-9975
Practice Address - Street 1:6502 NURSERY DR.
Practice Address - Street 2:SUITE 100
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77904
Practice Address - Country:US
Practice Address - Phone:361-575-0611
Practice Address - Fax:512-263-9975
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2025-01-30
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Provider Licenses
StateLicense IDTaxonomies
TXL88632084P0802X, 2084P0805X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry