Provider Demographics
NPI:1851757934
Name:NGUYEN, JENNIFER
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:BUI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:4828 WATERVIEW TOWN CENTER DR
Mailing Address - Street 2:STE 300
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-2385
Mailing Address - Country:US
Mailing Address - Phone:832-224-2667
Mailing Address - Fax:832-408-7935
Practice Address - Street 1:4828 WATERVIEW TOWN CENTER DR STE 300
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-2385
Practice Address - Country:US
Practice Address - Phone:322-242-6678
Practice Address - Fax:832-408-7935
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-05
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4952TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist