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NPI Code Detail

MEDICARE: ANGELINE NGUYEN OD

MEDICARE: ANGELINE NGUYEN OD
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
1152W00000XOptometrist9417TTX

General Provider Information

NPI Number : 1386121168
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELINE NGUYEN OD
Provider Business Mailing Address
First Line : 5900 COIT RD
Second Line :
City : PLANO
State : TX
Zip : 75023-5959
Country : US
Telephone Number : 972-985-1412
Fax Number : 972-767-4958
Provider Business Practice Location Address
First Line : 5900 COIT RD
Second Line :
City : PLANO
State : TX
Zip : 75023-5959
Country : US
Telephone Number : 972-985-1412
Fax Number : 972-767-4958
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2018
Last Update Date : 07/14/2021

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