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General NPI Number Information
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NPI Number | 1235876582
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Entity Type | Individual
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Provider Name | JENNY MY LINH NGUYEN OD
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Gender | Female
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Dates
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Enumeration Date | 05/18/2022
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Last Update Date | 05/18/2022
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Provider Practice Location Address
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Address Line | 1650 HIGHWAY 287 N
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City | MANSFIELD
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State | TX
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Zip | 76063-8852
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Country | US
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Telephone | 682-518-1177
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Fax | 682-518-8889
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Provider Business Mailing Address
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Address Line | 716 WILLINGTON DR
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City | ARLINGTON
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State | TX
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Zip | 76018-5113
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Country | US
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Telephone | 817-917-8430
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 10274
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License Number State | TX
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