Basic Information
| Provider Information | |||||||||
| NPI: | 1508057795 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DANG | ||||||||
| FirstName: | MICHELLE | ||||||||
| MiddleName: | NGUYEN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1780 W MCDERMOTT DR STE 200 | ||||||||
| Address2: | |||||||||
| City: | ALLEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750133363 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9729541469 | ||||||||
| FaxNumber: | 4692832743 | ||||||||
| Practice Location | |||||||||
| Address1: | 1001 MEDICAL PLAZA DR STE 130 | ||||||||
| Address2: | |||||||||
| City: | THE WOODLANDS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 77380 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2818065758 | ||||||||
| FaxNumber: | 2819645738 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/05/2007 | ||||||||
| LastUpdateDate: | 05/21/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | BP1-0028914 | TX | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207LP2900X | N8432 | TX | Y | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine |
ID Information
| ID | Type | State | Issuer | Description | 4660460348 | 01 | MYUTMB 4660460348 | OTHER |