Provider Demographics
NPI:1568095271
Name:NGUYEN, QUYEN NGO (OPTICIAN)
Entity Type:Individual
Prefix:MRS
First Name:QUYEN
Middle Name:NGO
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1830 S MASON RD STE 125
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-3240
Mailing Address - Country:US
Mailing Address - Phone:281-395-0056
Mailing Address - Fax:281-395-0058
Practice Address - Street 1:1830 S MASON RD STE 125
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-3240
Practice Address - Country:US
Practice Address - Phone:281-395-0056
Practice Address - Fax:281-395-0058
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-20
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX138517156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician