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General NPI Number Information
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NPI Number | 1497430102
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Entity Type | Individual
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Provider Name | JULIE THY NGUYEN OD
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Gender | Female
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Dates
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Enumeration Date | 06/20/2023
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Last Update Date | 06/20/2023
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Provider Practice Location Address
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Address Line | 7630 LITTLE RIVER TPKE STE 100
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City | ANNANDALE
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State | VA
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Zip | 22003-2614
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Country | US
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Telephone | 703-941-4111
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Fax | 703-941-3929
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Provider Business Mailing Address
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Address Line | 3947 FAIRVIEW DR
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City | FAIRFAX
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State | VA
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Zip | 22031-3402
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Country | US
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Telephone | 703-321-6798
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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 | 0618003259
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License Number State | VA
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