Provider Demographics
NPI:1982179164
Name:NGUYEN, HONG THI (OD)
Entity Type:Individual
Prefix:
First Name:HONG
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 1:411 N SECTION ST
Mailing Address - Street 2:
Mailing Address - City:FAIRHOPE
Mailing Address - State:AL
Mailing Address - Zip Code:36532-2649
Mailing Address - Country:US
Mailing Address - Phone:251-990-3937
Mailing Address - Fax:251-990-9990
Practice Address - Street 1:1624 N MCKENZIE ST
Practice Address - Street 2:
Practice Address - City:FOLEY
Practice Address - State:AL
Practice Address - Zip Code:36535-2248
Practice Address - Country:US
Practice Address - Phone:251-990-3937
Practice Address - Fax:251-990-9990
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-03
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-E17-TA-B33152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist