Provider Demographics
NPI:1386298479
Name:NGUYEN, KIMBERLY (DC)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20627 WOOD RAIN CT
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-7149
Mailing Address - Country:US
Mailing Address - Phone:281-763-1994
Mailing Address - Fax:
Practice Address - Street 1:22101 MORTON RANCH RD
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-7819
Practice Address - Country:US
Practice Address - Phone:281-763-1994
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-28
Last Update Date:2019-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14105111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor