Provider Demographics
NPI:1780698837
Name:NGUYEN, ANH NGOC (OD)
Entity type:Individual
Prefix:DR
First Name:ANH
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 1:5907 CORAL PETAL LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-6257
Mailing Address - Country:US
Mailing Address - Phone:281-804-2168
Mailing Address - Fax:
Practice Address - Street 1:310 OVERCREEK WAY
Practice Address - Street 2:
Practice Address - City:SEALY
Practice Address - State:TX
Practice Address - Zip Code:77474-3799
Practice Address - Country:US
Practice Address - Phone:979-885-7770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6972T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist