Provider Demographics
NPI:1932321445
Name:NGUYEN, KIM-THU THI (OD)
Entity Type:Individual
Prefix:DR
First Name:KIM-THU
Middle Name:THI
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 1:1201 LAKE WOODLANDS DR
Mailing Address - Street 2:SUITE #2112
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-5000
Mailing Address - Country:US
Mailing Address - Phone:281-298-3755
Mailing Address - Fax:281-298-7677
Practice Address - Street 1:1201 LAKE WOODLANDS DR
Practice Address - Street 2:SUITE #2112
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-5000
Practice Address - Country:US
Practice Address - Phone:281-298-3755
Practice Address - Fax:281-298-7677
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5264T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist