MEDICARE: STEVE N 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	5438TG	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

General Provider Information

NPI Number	:	1477648657
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVE N NGUYEN O.D.

Provider Business Mailing Address
First Line	:	7417 PRIMROSE DR.
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75063
Country	:	US
Telephone Number	:	972-409-0222
Fax Number	:

Provider Business Practice Location Address
First Line	:	2811 S. HAMPTON RD., STE#B
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75224
Country	:	US
Telephone Number	:	214-333-2020
Fax Number	:

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

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	10/29/2019

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