Provider Demographics
NPI:1942490305
Name:NGUYEN, THUY THANH (OD)
Entity Type:Individual
Prefix:
First Name:THUY
Middle Name:THANH
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 1:102 WOODLAND HWY STE 10
Mailing Address - Street 2:
Mailing Address - City:BELLE CHASSE
Mailing Address - State:LA
Mailing Address - Zip Code:70037-1674
Mailing Address - Country:US
Mailing Address - Phone:504-393-0002
Mailing Address - Fax:504-392-0770
Practice Address - Street 1:102 WOODLAND HWY STE 10
Practice Address - Street 2:
Practice Address - City:BELLE CHASSE
Practice Address - State:LA
Practice Address - Zip Code:70037-1674
Practice Address - Country:US
Practice Address - Phone:504-393-0002
Practice Address - Fax:504-392-0770
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-31
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1545-575T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5DV62Medicare PIN