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General NPI Number Information
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NPI Number | 1336521517
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Entity Type | Organization
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Legal Business Name | INGUYEN, PLLC
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Dates
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Enumeration Date | 06/24/2015
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Last Update Date | 09/21/2015
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Provider Practice Location Address
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Address Line | 6464 E NORTHWEST HWY SUITE 212. DOCTOR'S OFFICE
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City | DALLAS
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State | TX
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Zip | 75214-7800
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Country | US
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Telephone | 214-701-7773
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 820231
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City | DALLAS
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State | TX
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Zip | 75382-0231
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | KIMUYEN NGUYEN
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Credential |
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Telephone | 214-701-7773
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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 |
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License Number State |
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