Provider Demographics
NPI:1629482575
Name:WEI, DEBORAH NGUYEN (OD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:NGUYEN
Last Name:WEI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:DEBORAH
Other - Middle Name:KIEU
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:4821 BAYVIEW DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-1928
Mailing Address - Country:US
Mailing Address - Phone:972-754-5859
Mailing Address - Fax:
Practice Address - Street 1:2200 DALLAS PARKWAY
Practice Address - Street 2:SUITE 330
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-6225
Practice Address - Country:US
Practice Address - Phone:972-378-0946
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-19
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8395T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX369080ZJHZMedicare UPIN