Provider Demographics
NPI:1518044957
Name:NGUYEN, ROSA PHAM (OD)
Entity Type:Individual
Prefix:
First Name:ROSA
Middle Name:PHAM
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 1:1848 FM 359 RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-2049
Mailing Address - Country:US
Mailing Address - Phone:281-232-8257
Mailing Address - Fax:281-232-9183
Practice Address - Street 1:1848 FM 359 RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-2049
Practice Address - Country:US
Practice Address - Phone:281-232-8257
Practice Address - Fax:281-232-9183
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5922TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist