Provider Demographics
NPI:1942633813
Name:NGUYEN, QUAN D (OD)
Entity Type:Individual
Prefix:DR
First Name:QUAN
Middle Name:D
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 1:1932 WINCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76502-7370
Mailing Address - Country:US
Mailing Address - Phone:281-936-5498
Mailing Address - Fax:254-300-9937
Practice Address - Street 1:6801 W ADAMS AVE
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-0005
Practice Address - Country:US
Practice Address - Phone:254-661-0480
Practice Address - Fax:254-300-9937
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-15
Last Update Date:2019-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8145-T152W00000X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist