1902544059 NPI number — LE DONG QUAN NGUYEN M.S., CCC-SLP

Table of content: LE DONG QUAN NGUYEN M.S., CCC-SLP (NPI 1902544059)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902544059 NPI number — LE DONG QUAN NGUYEN M.S., CCC-SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NGUYEN
Provider First Name:
LE DONG QUAN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.S., CCC-SLP
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
NGUYEN
Provider Other First Name:
QUAN
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.S., CCC-SLP
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1902544059
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/14/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
288/D6 NAM KY KHOI NGHIA P. VO THI SAU, Q.3
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HO CHI MINH CITY
Provider Business Mailing Address State Name:
VIETNAM
Provider Business Mailing Address Postal Code:
722700
Provider Business Mailing Address Country Code:
VN
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6701 PINEMONT DR STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77092-3131
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
832-209-7830
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/26/2022

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  119579 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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