Active NPI
Dominic Anh-Phong Nguyen, PA-C
- Physician Assistant
- Houston, TX
National Provider Identifier
1760155857
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA14656
- Practice address
- 9130 Highway 6 S
Houston, TX 77083-6376 - Phone
- (281) 564-3300
- Fax
- (281) 564-2777
- NPI assigned
- Jul 26, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 | PA14656 | TX | Primary |
Addresses
Primary practice location
9130 Highway 6 S
Houston, TX 77083-6376
Mailing address
10907 Doud St
Houston, TX 77035-3146
Phone (281) 919-6912
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3501 W Holcombe Blvd
Memorial Hermann Gohealth UC
Houston, TX 77025-1313
Phone (713) 814-2680
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA14656 | TX | MD | Physician Assistant |
Interoperability endpoints
- dnguyen50610@memorialhermann.direct-ci.com
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Sugar Land, TX
- NPI 1730821208
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1627257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726704000000",
"number": "1760155857",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10907 DOUD ST",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770353146",
"telephone_number": "281-919-6912"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9130 HIGHWAY 6 S",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770836376",
"telephone_number": "281-564-3300",
"fax_number": "281-564-2777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "DOMINIC",
"middle_name": "ANH-PHONG",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-07-26",
"last_updated": "2024-09-19",
"certification_date": "2024-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA14656",
"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 Sep 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.