Provider Demographics
NPI:1396713111
Name:NGUYEN-NGO, HIEN K (MD)
Entity type:Individual
Prefix:
First Name:HIEN
Middle Name:K
Last Name:NGUYEN-NGO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 MEDICAL PKWY
Mailing Address - Street 2:SUITE 305
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-7858
Mailing Address - Country:US
Mailing Address - Phone:972-247-3937
Mailing Address - Fax:972-620-9635
Practice Address - Street 1:9 MEDICAL PKWY
Practice Address - Street 2:SUITE 305
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-7858
Practice Address - Country:US
Practice Address - Phone:972-247-3937
Practice Address - Fax:972-620-9635
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-08
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH0684174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00G95VMedicare UPIN