MEDICARE: NHUNG KIM DINH 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	11137	TX

General Provider Information

NPI Number	:	1417793324
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NHUNG KIM DINH OD

Provider Business Mailing Address
First Line	:	5118 HADDONSTONE DR
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76017-1890
Country	:	US
Telephone Number	:	817-682-1381
Fax Number	:

Provider Business Practice Location Address
First Line	:	1650 HIGHWAY 287 N
Second Line	:
City	:	MANSFIELD
State	:	TX
Zip	:	76063-8852
Country	:	US
Telephone Number	:	682-201-2883
Fax Number	:

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

Provider Enumeration Date	:	07/01/2024
Last Update Date	:	07/23/2025

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