Provider Demographics
NPI:1013100619
Name:KIM H NGUYEN, P.A.
Entity Type:Organization
Organization Name:KIM H NGUYEN, P.A.
Other - Org Name:CYPRESS VISION CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:KIM
Authorized Official - Middle Name:H
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:281-370-9890
Mailing Address - Street 1:13040 LOUETTA RD
Mailing Address - Street 2:SUITE 232
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-5216
Mailing Address - Country:US
Mailing Address - Phone:281-370-9890
Mailing Address - Fax:281-370-8196
Practice Address - Street 1:13040 LOUETTA RD
Practice Address - Street 2:SUITE 232
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-5216
Practice Address - Country:US
Practice Address - Phone:281-370-9890
Practice Address - Fax:281-370-8196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-27
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5437T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1659590602OtherNPI