MEDICARE: KARA C. NGUYEN OD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332H00000X	Eyewear Supplier

General Provider Information

NPI Number	:	1063548089
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KARA C. NGUYEN OD PA

Provider Business Mailing Address
First Line	:	2832 S HULEN ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76109-1514
Country	:	US
Telephone Number	:	917-926-6000
Fax Number	:	817-921-9429

Provider Business Practice Location Address
First Line	:	2832 S HULEN ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76109-1514
Country	:	US
Telephone Number	:	917-926-6046
Fax Number	:	817-921-9429

Authorized Official
Title or Position	:	OWNER
Name	:	DR. KARA C NGUYEN
Credential	:	OD
Telephone Number	:	817-926-6000

Provider Enumeration Date	:	02/26/2007
Last Update Date	:	09/22/2010

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