Provider Demographics
NPI:1336521517
Name:INGUYEN, PLLC
Entity Type:Organization
Organization Name:INGUYEN, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KIMUYEN
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-701-7773
Mailing Address - Street 1:PO BOX 820231
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75382-0231
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6464 E NORTHWEST HWY
Practice Address - Street 2:SUITE 212. DOCTOR'S OFFICE
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75214-7800
Practice Address - Country:US
Practice Address - Phone:214-701-7773
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-24
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty