Basic Information
Provider Information
NPI: 1457775058
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NGUYEN
FirstName: LIEN THUY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6431 FANNIN ST
Address2:  
City: HOUSTON
State: TX
PostalCode: 770301501
CountryCode: US
TelephoneNumber: 7134865900
FaxNumber: 7134865901
Practice Location
Address1: 10623 BELLAIRE BLVD STE C280
Address2:  
City: HOUSTON
State: TX
PostalCode: 770725242
CountryCode: US
TelephoneNumber: 7134865900
FaxNumber: 7134865901
Other Information
ProviderEnumerationDate: 02/18/2014
LastUpdateDate: 07/22/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/22/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363AM0700X  N Physician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
207Q00000XPA09085TXY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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