Provider Demographics
NPI:1053754192
Name:NGUYEN, DINO (MD)
Entity type:Individual
Prefix:DR
First Name:DINO
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 W HOLCOMBE BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-1313
Mailing Address - Country:US
Mailing Address - Phone:713-814-2680
Mailing Address - Fax:713-814-2681
Practice Address - Street 1:3501 W HOLCOMBE BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77025-1313
Practice Address - Country:US
Practice Address - Phone:713-814-2680
Practice Address - Fax:713-814-2681
Is Sole Proprietor?:No
Enumeration Date:2013-04-08
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ3251207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX361663301Medicaid
TX361663301Medicaid