Provider Demographics
NPI:1922499805
Name:NGUYEN, DUNG DUY (OD)
Entity Type:Individual
Prefix:
First Name:DUNG
Middle Name:DUY
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4420 N TARRANT PKWY STE 146
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-4922
Mailing Address - Country:US
Mailing Address - Phone:469-481-6688
Mailing Address - Fax:855-623-3937
Practice Address - Street 1:4420 N TARRANT PKWY STE 146
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-4922
Practice Address - Country:US
Practice Address - Phone:817-788-2020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-12
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8566T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist