Provider Demographics
NPI:1144584400
Name:NGUYEN, QUAN MANH (OD)
Entity Type:Individual
Prefix:DR
First Name:QUAN
Middle Name:MANH
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 1:10080 BELLAIRE BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77072-5249
Mailing Address - Country:US
Mailing Address - Phone:713-774-3211
Mailing Address - Fax:713-774-2310
Practice Address - Street 1:10080 BELLAIRE BLVD STE 105
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77072-5249
Practice Address - Country:US
Practice Address - Phone:713-774-3211
Practice Address - Fax:713-774-2310
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-01
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8027T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist