Provider Demographics
NPI:1164723458
Name:NGUYEN, JENNIFER DINH (OD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:DINH
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28429 STATE HIGHWAY 249
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-3307
Mailing Address - Country:US
Mailing Address - Phone:281-351-0871
Mailing Address - Fax:281-357-4813
Practice Address - Street 1:28429 STATE HIGHWAY 249
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-3307
Practice Address - Country:US
Practice Address - Phone:281-351-0871
Practice Address - Fax:281-357-4813
Is Sole Proprietor?:No
Enumeration Date:2010-11-03
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7639TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist