Individual provider Active NPI

Phuong Dinh Nguyen, NP

  • Pain Medicine Physician
  • Houston, TX
National Provider Identifier
1265033930
Registry record updated Feb 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
1029237 Issued in TX
Practice address
9717 Jones Rd Ste 107
Houston, TX 77065-4303
Phone
(713) 568-6095
Fax
(713) 965-4091
NPI assigned
Nov 8, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0000X F01210800 TX
General Practice Registered Nurse 163WG0000X 849550 TX
Pain Medicine Physician 208VP0000X 1029237 TX Primary

Addresses

Primary practice location

9717 Jones Rd Ste 107
Houston, TX 77065-4303

Mailing address

9717 Jones Rd Ste 107
Houston, TX 77065-4303
Phone (713) 568-6095

Other practice location 1

6565 Fannin St
Houston, TX 77030-2703
Phone (281) 836-1279

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
849550TXMDGeneral Practice Registered Nurse
1029237TXMDPain Medicine Physician
F01210800TXMDPain Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1604793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612310400000",
    "number": "1265033930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9717 JONES RD STE 107",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770654303",
            "telephone_number": "713-568-6095",
            "fax_number": "713-965-4091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9717 JONES RD STE 107",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770654303",
            "telephone_number": "713-568-6095",
            "fax_number": "713-965-4091"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6565 Fannin St",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770302703",
            "country_code": "US",
            "telephone_number": "281-836-1279",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "PHUONG",
        "middle_name": "DINH",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-08",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "TX",
            "license": "F01210800",
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "TX",
            "license": "849550",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "TX",
            "license": "1029237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.