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NPI Code Detail

MEDICARE: Q. D. NGUYEN PLLC

MEDICARE: Q. D. NGUYEN PLLC
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
1152WC0802XCorneal and Contact Management Optometrist6017TGTX

General Provider Information

NPI Number : 1346593829
Entity Type Code : Organization
Provider Name (Legal Business Name) : Q. D. NGUYEN PLLC
Provider Business Mailing Address
First Line : 4620 FRIARS LN
Second Line :
City : GRAND PRAIRIE
State : TX
Zip : 75052-3609
Country : US
Telephone Number : 832-668-4417
Fax Number : 972-237-0797
Provider Business Practice Location Address
First Line : 1228 N HIGHWAY 377
Second Line :
City : ROANOKE
State : TX
Zip : 76262-9122
Country : US
Telephone Number : 817-491-4994
Fax Number :
Authorized Official
Title or Position : OPTOMETRIC GLAUCOMA SPECIALIST
Name : DR. QUANG DUY NGUYEN
Credential : O.D.
Telephone Number : 832-668-4417
Provider Enumeration Date : 10/20/2012
Last Update Date : 11/26/2012

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