MEDICARE: DR. VU K NGUYEN O.D.

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	5744TG	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457354706
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VU K NGUYEN O.D.

Provider Business Mailing Address
First Line	:	5018 FAIRMONT PKWY
Second Line	:
City	:	PASADENA
State	:	TX
Zip	:	77505-3726
Country	:	US
Telephone Number	:	281-991-3937
Fax Number	:	281-991-6836

Provider Business Practice Location Address
First Line	:	5018 FAIRMONT PKWY
Second Line	:
City	:	PASADENA
State	:	TX
Zip	:	77505-3726
Country	:	US
Telephone Number	:	281-991-3937
Fax Number	:	281-991-6836

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	09/24/2019

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