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General NPI Number Information
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NPI Number | 1528477221
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Entity Type | Organization
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Legal Business Name | MVN CO
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Dates
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Enumeration Date | 08/06/2014
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Last Update Date | 08/06/2014
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Provider Practice Location Address
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Address Line | 8621 OHIO DR
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City | PLANO
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State | TX
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Zip | 75024-2264
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Country | US
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Telephone | 214-872-4404
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Fax | 214-872-4403
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Provider Business Mailing Address
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Address Line | 8621 OHIO DR
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City | PLANO
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State | TX
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Zip | 75024-2264
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Country | US
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Telephone | 214-872-4404
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Fax | 214-872-4403
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Authorized Official
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Title or Position | THERAPEUTIC OPTOMETRIST
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Name | MINH V NGUYEN
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Credential | O.D.
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Telephone | 512-762-9523
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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 | 7388T
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License Number State | TX
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