MEDICARE: DR. TRUC H 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
1	152W00000X	Optometrist	5197TG	TX

General Provider Information

NPI Number	:	1568585248
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TRUC H NGUYEN O.D.

Provider Business Mailing Address
First Line	:	4219 CROW VALLEY DR
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-4281
Country	:	US
Telephone Number	:	281-793-0721
Fax Number	:

Provider Business Practice Location Address
First Line	:	5330 FM 1640 RD STE 535
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77469
Country	:	US
Telephone Number	:	281-232-9922
Fax Number	:	281-232-9927

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

Provider Enumeration Date	:	04/09/2007
Last Update Date	:	05/21/2018

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