MEDICARE: DR. BOI-DIEU HOANG 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	9492TG	TX

General Provider Information

NPI Number	:	1700362480
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BOI-DIEU HOANG NGUYEN OD

Provider Business Mailing Address
First Line	:	18111 PRESTON RD STE 180
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75252-6009
Country	:	US
Telephone Number	:	972-248-0202
Fax Number	:	972-248-1711

Provider Business Practice Location Address
First Line	:	18111 PRESTON RD STE 180
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75252-6009
Country	:	US
Telephone Number	:	972-248-0202
Fax Number	:	972-248-1711

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

Provider Enumeration Date	:	07/16/2018
Last Update Date	:	08/08/2025

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