Provider Demographics
NPI:1083276711
Name:DR JOHN NGUYEN OD AND ASSOCIATES
Entity Type:Organization
Organization Name:DR JOHN NGUYEN OD AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:817-576-4419
Mailing Address - Street 1:2025 PLAMERA LN
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76131-2138
Mailing Address - Country:US
Mailing Address - Phone:817-576-4419
Mailing Address - Fax:817-576-4632
Practice Address - Street 1:1732 PRECINCT LINE RD
Practice Address - Street 2:
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76054-3165
Practice Address - Country:US
Practice Address - Phone:817-576-4419
Practice Address - Fax:817-576-4632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-02
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty