Active NPI
Olivia Nguyen
- Physician Assistant
- Houston, TX
National Provider Identifier
1376205930
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA15084
- Practice address
- 6410 Fannin St Ste 370
Houston, TX 77030-3004 - Phone
- (832) 325-6516
- NPI assigned
- Oct 12, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA15084 | TX | Primary |
Addresses
Primary practice location
6410 Fannin St Ste 370
Houston, TX 77030-3004
Mailing address
409 Heights Blvd Apt B
Houston, TX 77007-2519
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA15084 | TX | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1633996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635465600000",
"number": "1376205930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "409 HEIGHTS BLVD APT B",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770072519"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6410 FANNIN ST STE 370",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770303004",
"telephone_number": "832-325-6516"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "OLIVIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-10-12",
"last_updated": "2021-10-29",
"certification_date": "2021-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA15084",
"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 Oct 29, 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.