Provider Demographics
NPI:1235153933
Name:NGUYEN, JESSICA U (OD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:U
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2124 TOWN EAST MALL
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-4119
Mailing Address - Country:US
Mailing Address - Phone:972-613-3581
Mailing Address - Fax:972-279-1829
Practice Address - Street 1:2124 TOWN EAST MALL
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150
Practice Address - Country:US
Practice Address - Phone:972-613-3581
Practice Address - Fax:972-279-1829
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6948TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist