MEDICARE: CAROLINE T. NGUYEN, O.D., P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	6288T	TX

General Provider Information

NPI Number	:	1134464753
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAROLINE T. NGUYEN, O.D., P.A.

Provider Business Mailing Address
First Line	:	8309 WESSON RD
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76002-4262
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4900 S HULEN ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76132-1408
Country	:	US
Telephone Number	:	817-423-8300
Fax Number	:

Authorized Official
Title or Position	:	DOCTOR/OWNER
Name	:	DR. CAROLINE T NGUYEN
Credential	:	O.D.
Telephone Number	:	817-423-8300

Provider Enumeration Date	:	12/07/2012
Last Update Date	:	12/07/2012

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