Provider Demographics
NPI:1699747410
Name:NGUYEN, CONG THU (MD)
Entity type:Individual
Prefix:DR
First Name:CONG
Middle Name:THU
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:CT
Other - Middle Name:
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:27230 HIGHWAY 290 DEPT 300
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-2214
Mailing Address - Country:US
Mailing Address - Phone:832-237-7777
Mailing Address - Fax:713-456-3516
Practice Address - Street 1:27230 HIGHWAY 290 DEPT 300
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-2214
Practice Address - Country:US
Practice Address - Phone:832-237-7777
Practice Address - Fax:713-456-3516
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-06
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL0453207YX0905X, 207YX0602X, 207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
No207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic Allergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP000515M3Medicaid
TXP000515M3Medicaid
TX00515MMedicare ID - Type Unspecified