MEDICARE: DR. XUAN ANH VU NGUYEN O. D.

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	152W00000X	Optometrist	1330-464T	LA

General Provider Information

NPI Number	:	1093895559
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. XUAN ANH VU NGUYEN O. D.

Provider Business Mailing Address
First Line	:	8939 JEFFERSON HWY
Second Line	:	#118
City	:	BATON ROUGE
State	:	LA
Zip	:	70809-2472
Country	:	US
Telephone Number	:	713-854-0544
Fax Number	:

Provider Business Practice Location Address
First Line	:	3132 COLLEGE DR
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70808-3119
Country	:	US
Telephone Number	:	225-935-2251
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	07/08/2007

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