MEDICARE: ERIC NGUYEN OD

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	6454 TG	TX

General Provider Information

NPI Number	:	1144238452
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIC NGUYEN OD

Provider Business Mailing Address
First Line	:	8500 MAIN ST
Second Line	:	STE A
City	:	HOUSTON
State	:	TX
Zip	:	77025-2703
Country	:	US
Telephone Number	:	713-664-3434
Fax Number	:	713-300-3947

Provider Business Practice Location Address
First Line	:	8500 MAIN ST
Second Line	:	STE A
City	:	HOUSTON
State	:	TX
Zip	:	77025-2703
Country	:	US
Telephone Number	:	713-664-3434
Fax Number	:

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

Provider Enumeration Date	:	08/03/2006
Last Update Date	:	05/25/2021

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