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General NPI Number Information
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NPI Number | 1548942006
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Entity Type | Individual
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Provider Name | NICOLE NGUYEN-PHUOC OD
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Gender | Female
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Dates
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Enumeration Date | 08/03/2023
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Last Update Date | 08/03/2023
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Provider Practice Location Address
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Address Line | 16700 HOUSE HAHL RD BLDG 7
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City | CYPRESS
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State | TX
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Zip | 77433-6349
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Country | US
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Telephone | 281-550-4141
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Fax |
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Provider Business Mailing Address
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Address Line | 1095 BRITTMOORE RD APT 1227
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City | HOUSTON
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State | TX
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Zip | 77043-5059
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Country | US
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Telephone | 405-464-9960
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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 | 10912
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License Number State | TX
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