MEDICARE: MS. TIEU VY HOANG NGUYEN M.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	207WX0107X	Retina Specialist (Ophthalmology) Physician	S8480	TX
2	207W00000X	Ophthalmology Physician	S8084	TX

General Provider Information

NPI Number	:	1699154799
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TIEU VY HOANG NGUYEN M.D.

Provider Business Mailing Address
First Line	:	6300 WEST LOOP S STE 500
Second Line	:
City	:	BELLAIRE
State	:	TX
Zip	:	77401-2903
Country	:	US
Telephone Number	:	713-524-3434
Fax Number	:	713-513-5613

Provider Business Practice Location Address
First Line	:	6921 BRISBANE CT STE 200
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-7094
Country	:	US
Telephone Number	:	713-524-3434
Fax Number	:	713-524-3220

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

Provider Enumeration Date	:	05/21/2015
Last Update Date	:	08/26/2020

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