Provider Demographics
NPI:1619165479
Name:ROBERT THUAN NGUYEN, OD, PA
Entity Type:Organization
Organization Name:ROBERT THUAN NGUYEN, OD, PA
Other - Org Name:KLEINWOOD VISION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:832-717-0900
Mailing Address - Street 1:7312 LOUETTA RD
Mailing Address - Street 2:SUITE B116
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-6175
Mailing Address - Country:US
Mailing Address - Phone:832-717-0900
Mailing Address - Fax:832-717-0908
Practice Address - Street 1:7312 LOUETTA RD
Practice Address - Street 2:SUITE B116
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-6175
Practice Address - Country:US
Practice Address - Phone:832-717-0900
Practice Address - Fax:832-717-0908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-05
Last Update Date:2013-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6459TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX171840501Medicaid
TX00600XMedicare PIN