Physician Compare National (NPI:1588016919)

HEALTHCARE PROVIDER: SALLY TAM NGUYEN O.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1588016919
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8022363209
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20180611002636
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	NGUYEN
	Individual professional last name
Provider First Name	SALLY
	Individual professional first name
Provider Middle Name	TAM
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
	Individual professional's medical school
Graduation Year	2016
	Individual professional's medical school graduation year
Primary Specialty	OPTOMETRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	FARAH HASSAM LLC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	7416234729
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	2
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	8055 CHURCHILL WAY
	Group Practice or individual's line 1 address
Line 2 Street Address	SEE CLEAR EYE CARE
	Group Practice or individual's line 2 address
City	DALLAS
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	752512149
	Group Practice or individual's zip code (9 digits when available)
Phone Number	4696807561
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y