Provider Demographics
NPI:1346593829
Name:Q. D. NGUYEN PLLC
Entity Type:Organization
Organization Name:Q. D. NGUYEN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIC GLAUCOMA SPECIALIST
Authorized Official - Prefix:DR
Authorized Official - First Name:QUANG
Authorized Official - Middle Name:DUY
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:832-668-4417
Mailing Address - Street 1:4620 FRIARS LN
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-3609
Mailing Address - Country:US
Mailing Address - Phone:832-668-4417
Mailing Address - Fax:972-237-0797
Practice Address - Street 1:1228 N HIGHWAY 377
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:TX
Practice Address - Zip Code:76262-9122
Practice Address - Country:US
Practice Address - Phone:817-491-4994
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-20
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6017TG152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty