Provider Demographics
NPI:1699775908
Name:NGUYEN, SON VI (MD)
Entity type:Individual
Prefix:DR
First Name:SON
Middle Name:VI
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1015 W 8TH AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79101-2031
Mailing Address - Country:US
Mailing Address - Phone:806-371-0083
Mailing Address - Fax:806-371-0511
Practice Address - Street 1:1015 W 8TH AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79101-2031
Practice Address - Country:US
Practice Address - Phone:806-371-0083
Practice Address - Fax:806-371-0511
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-28
Last Update Date:2009-10-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXH18142084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX131615002Medicaid
TX131615002Medicaid
TXD42702Medicare UPIN