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General NPI Number Information
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NPI Number | 1356620645
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Entity Type | Organization
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Legal Business Name | THI M. NGUYEN OD, PLLC
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Dates
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Enumeration Date | 08/04/2011
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Last Update Date | 11/09/2011
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Provider Practice Location Address
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Address Line | 1959 W NORTHWEST HWY
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City | DALLAS
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State | TX
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Zip | 75220-2313
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Country | US
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Telephone | 972-506-3046
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Fax | 972-506-3095
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Provider Business Mailing Address
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Address Line | PO BOX 324
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City | ADDISON
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State | TX
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Zip | 75001-0324
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Country | US
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Telephone | 972-506-3046
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Fax | 972-506-3095
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Authorized Official
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Title or Position | THERAPEUTIC OPTOMETRIST
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Name | DR. THI NGUYEN
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Credential |
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Telephone | 817-307-5357
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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 | 7094TG
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License Number State | TX
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