MEDICARE: DR. REGINA THUY VY 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	7262TG	TX

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

General Provider Information

NPI Number	:	1619131869
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. REGINA THUY VY NGUYEN O.D.

Provider Business Mailing Address
First Line	:	14870 SPACE CENTER BLVD
Second Line	:	SUITE H
City	:	HOUSTON
State	:	TX
Zip	:	77062-2368
Country	:	US
Telephone Number	:	281-984-7515
Fax Number	:	302-394-1563

Provider Business Practice Location Address
First Line	:	14870 SPACE CENTER BLVD
Second Line	:	SUITE H
City	:	HOUSTON
State	:	TX
Zip	:	77062-2368
Country	:	US
Telephone Number	:	281-984-7515
Fax Number	:	302-394-1563

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

Provider Enumeration Date	:	07/16/2008
Last Update Date	:	07/18/2016

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