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General NPI Number Information
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NPI Number | 1811517899
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Entity Type | Individual
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Provider Name | THUY THANH NGUYEN
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Gender | Female
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Dates
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Enumeration Date | 04/20/2020
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Last Update Date | 03/06/2023
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Provider Practice Location Address
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Address Line | 555 WILLARD AVE
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City | NEWINGTON
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State | CT
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Zip | 06111-2631
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Country | US
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Telephone | 860-667-6742
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Fax |
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Provider Business Mailing Address
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Address Line | 8407 KIRKVILLE DR
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City | HOUSTON
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State | TX
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Zip | 77089-2287
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Country | US
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Telephone | 832-738-3073
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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 | 3187
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 10023
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 3878-35
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License Number State | WI
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Taxonomy #4
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 5469
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License Number State | MA
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