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General NPI Number Information
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NPI Number | 1710329727
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Entity Type | Organization
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Legal Business Name | DAT NGUYEN OD PLLC
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Dates
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Enumeration Date | 07/19/2013
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Last Update Date | 10/22/2016
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Provider Practice Location Address
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Address Line | 7111 MARVIN D LOVE FWY STE 101
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City | DALLAS
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State | TX
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Zip | 75237-3112
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Country | US
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Telephone | 972-298-5379
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Fax | 972-842-7668
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Provider Business Mailing Address
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Address Line | 7111 MARVIN D LOVE FWY STE 101
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City | DALLAS
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State | TX
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Zip | 75237-3112
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Country | US
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Telephone | 972-298-5379
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Fax | 972-842-7668
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DAT NGUYEN
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Credential | OD
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Telephone | 972-298-5379
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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 | 7469TG
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License Number State | TX
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