Individual provider Active NPI

Nicole Ngoc Nguyen, DO

  • Family Medicine Physician
  • Prosper, TX
National Provider Identifier
1073683462
Registry record updated Apr 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M4398 Issued in TX
Practice address
4530 W University Dr
Prosper, TX 75078-9090
Phone
(469) 607-7504
NPI assigned
Nov 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X M4398 TX Primary

Addresses

Primary practice location

4530 W University Dr
Prosper, TX 75078-9090

Mailing address

4530 W University Dr
Prosper, TX 75078-9090
Phone (469) 607-7504

Other identifiers 1

IdentifierTypeStateIssuer
8DY499OtherTXBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071015000536 TX Practitioner - Family Practice 1557457090 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of North Texas HSC, College of Osteopathic Med, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primary Health Physicians PLLCGroup PAC ID 7810237740, 240 clinicians

Practice addresses (Care Compare)

2310 W University Dr
Suite 1500
Denton, TX 76201-1650
Phone (940) 220-5901

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Integrative Emergency Services Physician Group PA CurrentSince Jan 14, 2017 Accepting new patients
Healogics Specialty Physicians of Texas, PLLC Family Medicine CurrentSince Jul 16, 2018 Accepting new patients
Primary Health Physicians, PLLC CurrentSince Feb 11, 2019 Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

1105 Central Expy N
Ste 2210
Allen, TX 75013
Phone (972) 747-4325

4835 Lyndon B Johnson Fwy
Ste 900
Dallas, TX 75244
Phone (469) 340-1366

2310 W University Dr
#1500
Denton, TX 76201
Phone (940) 220-5901

1575 S Main St
Ft Worth, TX 76104
Phone (817) 702-8828

1500 S Main St
Ft Worth, TX 76104
Phone (817) 921-3431

4530 W University Dr
Prosper, TX 75078
Phone (469) 607-7504

2600 N US Highway 75
Sherman, TX 75090
Phone (903) 416-3650

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776816000000",
    "number": "1073683462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4530 W UNIVERSITY DR",
            "city": "PROSPER",
            "state": "TX",
            "postal_code": "750789090",
            "telephone_number": "469-607-7504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4530 W UNIVERSITY DR",
            "city": "PROSPER",
            "state": "TX",
            "postal_code": "750789090",
            "telephone_number": "469-607-7504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "NICOLE",
        "middle_name": "NGOC",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2026-04-22",
        "certification_date": "2026-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "M4398",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "8DY499",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prosper, TX

Sources for this page

Verify at the official NPI Registry.