Provider Demographics
NPI:1760725980
Name:NGUYEN, THY PHAM (OD)
Entity Type:Individual
Prefix:
First Name:THY
Middle Name:PHAM
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 1:9595 SIX PINES DR
Mailing Address - Street 2:SUITE #1350A
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-1531
Mailing Address - Country:US
Mailing Address - Phone:281-298-3755
Mailing Address - Fax:
Practice Address - Street 1:9595 SIX PINES DR
Practice Address - Street 2:SUITE #1350A
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-1531
Practice Address - Country:US
Practice Address - Phone:281-298-3755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-05
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8130TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist