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General NPI Number Information
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NPI Number | 1548098197
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Entity Type | Individual
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Provider Name | TIFFANY NGUYEN OD
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Gender | Female
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Dates
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Enumeration Date | 07/24/2024
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Last Update Date | 07/24/2024
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Provider Practice Location Address
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Address Line | 201 MEADOW FARM RD
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City | LAFAYETTE
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State | LA
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Zip | 70508-7277
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Country | US
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Telephone | 337-541-7040
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Fax |
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Provider Business Mailing Address
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Address Line | 108 TIMBER BARK RD
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City | LAFAYETTE
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State | LA
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Zip | 70508-1858
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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 |
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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 | 2040-986AT
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License Number State | LA
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