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NPI Code Detail

MEDICARE: DR. DAT NGUYEN O.D.

MEDICARE: DR. DAT 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
1152W00000XOptometrist7469TTX

General Provider Information

NPI Number : 1841420866
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAT NGUYEN O.D.
Provider Business Mailing Address
First Line : 6419 SKILLMAN ST
Second Line :
City : DALLAS
State : TX
Zip : 75231-7109
Country : US
Telephone Number : 214-503-0997
Fax Number :
Provider Business Practice Location Address
First Line : 6419 SKILLMAN ST
Second Line :
City : DALLAS
State : TX
Zip : 75231-7109
Country : US
Telephone Number : 214-503-0997
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2009
Last Update Date : 12/28/2012

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