Provider Demographics
NPI:1275591950
Name:NGUYEN, HANH MAI (OD)
Entity Type:Individual
Prefix:DR
First Name:HANH
Middle Name:MAI
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 1:4301 GARTH RD STE 100
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521
Mailing Address - Country:US
Mailing Address - Phone:281-422-2020
Mailing Address - Fax:281-422-4959
Practice Address - Street 1:4301 GARTH RD STE 100
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-3157
Practice Address - Country:US
Practice Address - Phone:281-422-2020
Practice Address - Fax:281-422-4959
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5793TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX182415301Medicaid
TX182415302Medicaid
8G7187Medicare PIN
8F4227Medicare PIN
TX182415301Medicaid