Provider Demographics
NPI:1396126538
Name:NGUYEN, VINH (OD)
Entity type:Individual
Prefix:
First Name:VINH
Middle Name:
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 1:10000 RESEARCH BLVD
Mailing Address - Street 2:STE 150
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-5814
Mailing Address - Country:US
Mailing Address - Phone:512-694-7158
Mailing Address - Fax:
Practice Address - Street 1:3138 SE MILITARY DR STE 112
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78223-3895
Practice Address - Country:US
Practice Address - Phone:210-333-8865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-13
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8725TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist