Provider Demographics
NPI:1689245540
Name:PHUONG T. NGUYEN, O.D., PLLC
Entity Type:Organization
Organization Name:PHUONG T. NGUYEN, O.D., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PHUONG
Authorized Official - Middle Name:THUY
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-792-0113
Mailing Address - Street 1:9301 FOREST LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-4205
Mailing Address - Country:US
Mailing Address - Phone:972-792-0113
Mailing Address - Fax:972-792-0115
Practice Address - Street 1:9301 FOREST LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-4205
Practice Address - Country:US
Practice Address - Phone:972-792-0113
Practice Address - Fax:972-792-0115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-01
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty