Provider Demographics
NPI:1245899566
Name:NGUYEN, KAREN NGOC (OD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:NGOC
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 1:1971 BARRON LN
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76112-5353
Mailing Address - Country:US
Mailing Address - Phone:817-291-8451
Mailing Address - Fax:
Practice Address - Street 1:4800 S HULEN ST STE 2720
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132-1465
Practice Address - Country:US
Practice Address - Phone:817-346-2186
Practice Address - Fax:817-370-7902
Is Sole Proprietor?:No
Enumeration Date:2019-06-10
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9665T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist