Provider Demographics
NPI:1083023881
Name:NGUYEN, QUOC (OD)
Entity Type:Individual
Prefix:
First Name:QUOC
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7101 W GRAND PKWY S STE 170B
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-8656
Mailing Address - Country:US
Mailing Address - Phone:346-222-0205
Mailing Address - Fax:
Practice Address - Street 1:7101 W GRAND PKWY S STE 170B
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-8656
Practice Address - Country:US
Practice Address - Phone:346-222-0205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-05
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8422TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist