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NPI Code Detail

MEDICARE: DR. JOHN K NGUYEN O.D.

MEDICARE:  DR. JOHN K 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
1152W00000XOptometristTX6758TX

General Provider Information

NPI Number : 1154589067
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN K NGUYEN O.D.
Provider Business Mailing Address
First Line : 5619 W LOOP 1604 N STE 114
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78253-5795
Country : US
Telephone Number : 210-647-0728
Fax Number :
Provider Business Practice Location Address
First Line : 5619 W LOOP 1604 N STE 114
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78253-5795
Country : US
Telephone Number : 210-492-4188
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2008
Last Update Date : 06/04/2009

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Directions to “ DR. JOHN K NGUYEN O.D.” Practice Location

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