Provider Demographics
NPI:1568743771
Name:THUY THANH NGUYEN, LLC
Entity Type:Organization
Organization Name:THUY THANH NGUYEN, LLC
Other - Org Name:BELLE CHASSE OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THUY
Authorized Official - Middle Name:T
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:504-393-0002
Mailing Address - Street 1:102 WOODLAND HWY
Mailing Address - Street 2:STE 10
Mailing Address - City:BELLE CHASSE
Mailing Address - State:LA
Mailing Address - Zip Code:70037-1674
Mailing Address - Country:US
Mailing Address - Phone:504-393-0002
Mailing Address - Fax:504-392-0770
Practice Address - Street 1:102 WOODLAND HWY
Practice Address - Street 2:STE 10
Practice Address - City:BELLE CHASSE
Practice Address - State:LA
Practice Address - Zip Code:70037-1674
Practice Address - Country:US
Practice Address - Phone:504-393-0002
Practice Address - Fax:504-392-0770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-31
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1545-575T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1175340Medicaid
LA1175340Medicaid