MEDICARE: JENNIE 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	8367	TX
2	152W00000X	Optometrist	046.010169	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0001604768	OTHER	IL	BLUE CROSS & BLUE SHIELD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427293638
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIE NGUYEN OD

Provider Business Mailing Address
First Line	:	1836 STEWART DR
Second Line	:
City	:	CARROLLTON
State	:	TX
Zip	:	75010-6329
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4600 GREENVILLE AVE
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75206-5062
Country	:	US
Telephone Number	:	214-363-5991
Fax Number	:

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

Provider Enumeration Date	:	12/03/2008
Last Update Date	:	01/05/2018

Similar Medicare Providers

1801722038 — ZAHRA SOMANI
Practice Location Address:

4600 GREENVILLE AVE STE 140
DALLAS, TX
75206-5062

Practice Phone: 214-810-4653
Practice Fax:

1881922870 — KAREN ANN WITHERSPOON CCP
Practice Location Address:

3329 ROYAL LN
DALLAS, TX
75229-5062

Practice Phone: 972-814-4809
Practice Fax:

1760151583 — TALIAH MCGHEE
Practice Location Address:

1111 W MOCKINGBIRD LN STE 480
DALLAS, TX
75247-5062

Practice Phone: 972-489-5552
Practice Fax:

1831882950 — JOILAVIA GRAVES
Practice Location Address:

1111 W MOCKINGBIRD LN STE 480
DALLAS, TX
75247-5062

Practice Phone: 972-489-5552
Practice Fax:

1306522966 — ERIKA ELIZABETH PERNELL
Practice Location Address:

1111 W MOCKINGBIRD LN STE 480
DALLAS, TX
75247-5062

Practice Phone: 972-373-4842
Practice Fax:

1033994454 — SHEWONNER ARMSTRONG
Practice Location Address:

1111 W MOCKINGBIRD LN STE 480
DALLAS, TX
75247-5062

Practice Phone: 972-459-9992
Practice Fax:

Directions to “ JENNIE NGUYEN OD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.