Provider Demographics
NPI:1629365291
Name:NGUYEN, THAO THIEN (OD)
Entity Type:Individual
Prefix:DR
First Name:THAO
Middle Name:THIEN
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:PO BOX 8176
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77288-8176
Mailing Address - Country:US
Mailing Address - Phone:281-235-5443
Mailing Address - Fax:
Practice Address - Street 1:1560 ELDRIDGE PKWY
Practice Address - Street 2:SUITE 136
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-1761
Practice Address - Country:US
Practice Address - Phone:281-235-5443
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-05
Last Update Date:2011-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7728152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist