Provider Demographics
NPI:1992362578
Name:NGUYEN, THANH AN (DPM)
Entity type:Individual
Prefix:DR
First Name:THANH
Middle Name:AN
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 23714
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4488
Mailing Address - Country:US
Mailing Address - Phone:210-923-9200
Mailing Address - Fax:
Practice Address - Street 1:102 PALO ALTO RD STE 133
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78211-3792
Practice Address - Country:US
Practice Address - Phone:210-923-9200
Practice Address - Fax:210-923-9202
Is Sole Proprietor?:No
Enumeration Date:2019-05-20
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3182213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist