Provider Demographics
NPI:1851727820
Name:NGUYEN, THERESA Q (OD)
Entity Type:Individual
Prefix:DR
First Name:THERESA
Middle Name:Q
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 1:901 S MOPAC EXPY
Mailing Address - Street 2:BARTON OAKS PLAZA 4, SUITE 350
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:901 S MOPAC EXPY
Practice Address - Street 2:BARTON OAKS PLAZA
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746
Practice Address - Country:US
Practice Address - Phone:512-347-0255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-22
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM654152W00000X
TX9877152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist