Provider Demographics
NPI:1689355885
Name:NGUYEN, JESSICA LE (OD)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:LE
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 1:8800 HIGHWAY 6 STE 100
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-7117
Mailing Address - Country:US
Mailing Address - Phone:281-778-9912
Mailing Address - Fax:281-778-9113
Practice Address - Street 1:8800 HIGHWAY 6 STE 100
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-7117
Practice Address - Country:US
Practice Address - Phone:281-778-9912
Practice Address - Fax:281-778-9113
Is Sole Proprietor?:No
Enumeration Date:2023-07-31
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10932T152WC0802X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management