Provider Demographics
NPI:1679888481
Name:HUNG DUY NGUYEN O.D., LLC
Entity Type:Organization
Organization Name:HUNG DUY NGUYEN O.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:ARNOLD
Authorized Official - Last Name:ZOOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-336-0987
Mailing Address - Street 1:1012 WEDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WOODWAY
Mailing Address - State:TX
Mailing Address - Zip Code:76712-3723
Mailing Address - Country:US
Mailing Address - Phone:954-336-0987
Mailing Address - Fax:903-723-2219
Practice Address - Street 1:4320 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76710-6906
Practice Address - Country:US
Practice Address - Phone:254-766-4200
Practice Address - Fax:254-776-4244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-17
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7509T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty