Provider Demographics
NPI:1700083474
Name:NGUYEN, THANH P
Entity Type:Individual
Prefix:
First Name:THANH
Middle Name:P
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11339 VETERANS MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77067-3799
Mailing Address - Country:US
Mailing Address - Phone:281-580-7555
Mailing Address - Fax:281-580-7799
Practice Address - Street 1:11339 VETERANS MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77067-3799
Practice Address - Country:US
Practice Address - Phone:281-580-7555
Practice Address - Fax:281-580-7799
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician