Provider Demographics
NPI:1972130581
Name:NGUYEN, MADALYN TRAN (DO)
Entity type:Individual
Prefix:DR
First Name:MADALYN
Middle Name:TRAN
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:11801 DOMAIN BLVD STE C1120
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-3429
Mailing Address - Country:US
Mailing Address - Phone:512-276-3376
Mailing Address - Fax:512-666-3244
Practice Address - Street 1:11801 DOMAIN BLVD STE C1120
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-3429
Practice Address - Country:US
Practice Address - Phone:512-276-3376
Practice Address - Fax:512-666-3244
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-24
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXV4449207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology