Provider Demographics
NPI:1770037129
Name:DR. BACH NGUYEN, O.D. AND ASSOCIATES PLLC
Entity Type:Organization
Organization Name:DR. BACH NGUYEN, O.D. AND ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BACH
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:512-571-8350
Mailing Address - Street 1:17307 KLEE CIR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-6264
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6155 EASTEX FWY
Practice Address - Street 2:STE 699
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-6718
Practice Address - Country:US
Practice Address - Phone:512-571-8350
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-15
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8951T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty