Individual provider Active NPI

Christine Quynh Anh Nguyen

  • Pediatric Physical Therapist
  • Pearland, TX
National Provider Identifier
1467062547
Registry record updated Aug 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
1330478 Issued in TX
Practice address
2011 Broadway St Ste 130
Pearland, TX 77581-5945
Phone
(281) 997-8509
NPI assigned
Aug 4, 2020
Last updated
Aug 4, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X 1330478 TX Primary

Addresses

Primary practice location

2011 Broadway St Ste 130
Pearland, TX 77581-5945

Mailing address

105 Cimmaron Trail
Apt 2068
Irving, TX 75063

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tally M Ward CurrentSince Oct 28, 2021 Accepting new patients
Riverkids Houston Therapy, LLC PastSince Sep 23, 2024 Accepting new patients

Locations

200 N Interstate 35 Rd
Ste C
Red Oak, TX 75154
Phone (469) 917-0805

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1596499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596499200000",
    "number": "1467062547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 CIMMARON TRAIL",
            "address_2": "APT 2068",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "75063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 BROADWAY ST STE 130",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775815945",
            "telephone_number": "281-997-8509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "CHRISTINE",
        "middle_name": "QUYNH ANH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-04",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "TX",
            "license": "1330478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2020; 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.