Provider Demographics
NPI:1942314943
Name:NGUYEN, HOA THI
Entity Type:Individual
Prefix:
First Name:HOA
Middle Name:THI
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1509 DUTCHMAN CREEK DR
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-3661
Mailing Address - Country:US
Mailing Address - Phone:713-502-8428
Mailing Address - Fax:
Practice Address - Street 1:6121 W PARK BLVD
Practice Address - Street 2:SUITE C216
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-6221
Practice Address - Country:US
Practice Address - Phone:972-400-5522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6917TG152W00000X, 152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management