Provider Demographics
NPI:1699015040
Name:NGUYEN, HONG PHUNG (FNP)
Entity type:Individual
Prefix:
First Name:HONG
Middle Name:PHUNG
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3044 OLD DENTON RD STE 317
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-5017
Mailing Address - Country:US
Mailing Address - Phone:972-242-4440
Mailing Address - Fax:972-242-4949
Practice Address - Street 1:3044 OLD DENTON RD STE 317
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-5017
Practice Address - Country:US
Practice Address - Phone:940-242-4440
Practice Address - Fax:940-242-4949
Is Sole Proprietor?:No
Enumeration Date:2013-02-21
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX771286363LF0000X
TXAP123266363LP2300X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX275598YL7BOtherMEDICARE - DALLAS
TX275598YL7BOtherMEDICARE - DALLAS