Provider Demographics
NPI:1790712149
Name:NHAN, DIANE THUY (OD)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:THUY
Last Name:NHAN
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 1:5717 SARATOGA BLVD STE 113
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-4206
Mailing Address - Country:US
Mailing Address - Phone:361-993-7200
Mailing Address - Fax:361-993-7203
Practice Address - Street 1:5717 SARATOGA BLVD STE 113
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-4206
Practice Address - Country:US
Practice Address - Phone:361-993-7200
Practice Address - Fax:361-993-7203
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6678T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX26-1400586OtherEIN