Individual provider Active NPI

Theresa HT Nguyen, DPM

  • Primary Podiatric Medicine Podiatrist
  • Plano, TX
National Provider Identifier
1487959219
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
3185 Issued in TX
Practice address
2633 Dallas Pkwy Ste 100
Plano, TX 75093-4715
Phone
(972) 403-7733
Fax
(972) 403-7744
NPI assigned
Jan 26, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X PO60335864 WA
Primary Podiatric Medicine PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213EP1101X 3185 TX Primary

Addresses

Primary practice location

2633 Dallas Pkwy Ste 100
Plano, TX 75093-4715

Mailing address

2633 Dallas Pkwy Ste 100
Plano, TX 75093-4715
Phone (972) 403-7733

Other practice location 1

1610 Bishop Rd SW Bldg 7
Tumwater, WA 98512-7303
Phone (360) 754-3338

Other practice location 2

1610 Bishop Rd SW Ste 101
Tumwater, WA 98512-7303
Phone (360) 754-3338

Other practice location 3

404 Black Hills Ln SW Ste B
Olympia, WA 98502-8148
Phone (360) 943-1400

Other practice location 4

3929 Bridgeport Way W Ste 308
University Place, WA 98466-4455
Phone (253) 272-2999

Other practice location 5

5210 Corporate Center Ct SE Ste A
Lacey, WA 98503-5952
Phone (360) 764-8293

Other practice location 6

1220 W 1st St Ste B
Centralia, WA 98531-3018
Phone (360) 736-4151

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140326000926 WA Practitioner - PodiatryPractitioner - Sports Medicine 4789815259 Reassigns benefits to 3 organizations
I20230718002904 TX Practitioner - Podiatry 4789815259 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jeremiah Graff DPM P aGroup PAC ID 4789745027, 7 clinicians

Practice addresses (Care Compare)

6901 Snider PLZ
Suite 150
Dallas, TX 75205-5603
Phone (972) 403-7733

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Varicose vein removal58
Removal of tissue970
Removal of skin lesions1-10
Removal of nail tissue899
Removal or shaving of skin growth29

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3185TXMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Stanley & Utterback Single Specialty CurrentSince Jul 1, 2017 Accepting new patients
Isb.Inc Single Specialty CurrentSince Dec 26, 2018 Accepting new patients
Isb, Inc Single Specialty Current Accepting new patients
Jeremiah Graff DPM P a Single Specialty CurrentSince Aug 1, 2023 Accepting new patients
Fasa Family Wellness, PLLC CurrentSince Mar 30, 2021 Accepting new patients
J. Graff Surgery Center Inc Past Accepting new patients
Texas Orthopedic Specialists, PLLC Single Specialty Past Accepting new patients

Locations

456 State Highway 121
Unit 140
Coppell, TX 75019
Phone (972) 403-7784

6901 Snider Plz
Ste 150
Dallas, TX 75205
Phone (214) 389-6475

7150 N President George Bush Hwy
Ste 102
Garland, TX 75044

1400 N Coit Rd
Ste 503
McKinney, TX 75071

2633 Dallas Pkwy
Ste 100
Plano, TX 75093
Phone (469) 562-1992

2633 Dallas Pkwy
Ste 102
Plano, TX 75093

1220 W 1st St
#B
Centralia, WA 98531
Phone (360) 736-4151

10056 SE 240th St
Ste D
Kent, WA 98031
Phone (206) 992-9914

5210 Corporate Center Ct SE
Ste A
Lacey, WA 98503
Phone (360) 754-3338

2828 Martin Way E
Olympia, WA 98506
Phone (360) 943-9600

404 Black Hills Ln SW
Ste B
Olympia, WA 98502
Phone (360) 704-4745

2001 152nd Ave NE
Redmond, WA 98052
Phone (425) 643-8901

1610 Bishop Rd SW
Ste 101
Tumwater, WA 98512
Phone (360) 754-3338

1610 Bishop Rd SW
Ste 7
Tumwater, WA 98512
Phone (360) 754-3338

1610 Bishop Rd SW
Bldg 7
Tumwater, WA 98512
Phone (314) 323-2727

3929 Bridgeport Way W
Ste 308
University Place, WA 98466
Phone (253) 272-2999

Interoperability endpoints

  • Direct secure messaging: theresanguyen@faasa-wa.direct.office.nextgen.com

Organizations & group practices 8

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": "1296000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1487959219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2633 DALLAS PKWY STE 100",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750934715",
            "telephone_number": "972-403-7733",
            "fax_number": "972-403-7744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2633 DALLAS PKWY STE 100",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750934715",
            "telephone_number": "972-403-7733",
            "fax_number": "972-403-7744"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1610 Bishop Rd SW Bldg 7",
            "address_purpose": "LOCATION",
            "city": "Tumwater",
            "state": "WA",
            "postal_code": "985127303",
            "country_code": "US",
            "telephone_number": "360-754-3338",
            "fax_number": "360-753-4861",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1610 Bishop Rd SW Ste 101",
            "address_purpose": "LOCATION",
            "city": "Tumwater",
            "state": "WA",
            "postal_code": "985127303",
            "country_code": "US",
            "telephone_number": "360-754-3338",
            "fax_number": "360-753-4861",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "404 Black Hills Ln SW Ste B",
            "address_purpose": "LOCATION",
            "city": "Olympia",
            "state": "WA",
            "postal_code": "985028148",
            "country_code": "US",
            "telephone_number": "360-943-1400",
            "fax_number": "360-943-0660",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3929 Bridgeport Way W Ste 308",
            "address_purpose": "LOCATION",
            "city": "University Place",
            "state": "WA",
            "postal_code": "984664455",
            "country_code": "US",
            "telephone_number": "253-272-2999",
            "fax_number": "253-272-4699",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5210 Corporate Center Ct SE Ste A",
            "address_purpose": "LOCATION",
            "city": "Lacey",
            "state": "WA",
            "postal_code": "985035952",
            "country_code": "US",
            "telephone_number": "360-764-8293",
            "fax_number": "360-706-2560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1220 W 1st St Ste B",
            "address_purpose": "LOCATION",
            "city": "Centralia",
            "state": "WA",
            "postal_code": "985313018",
            "country_code": "US",
            "telephone_number": "360-736-4151",
            "fax_number": "360-736-4154",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "THERESA",
        "middle_name": "HT",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-26",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "WA",
            "license": "PO60335864",
            "primary": false
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "TX",
            "license": "3185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.