Provider Demographics
NPI:1538176748
Name:NGUYEN, TIN (OD)
Entity type:Individual
Prefix:DR
First Name:TIN
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:23108 SEVEN MEADOWS PKWY
Mailing Address - Street 2:STE 250
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494
Mailing Address - Country:US
Mailing Address - Phone:281-371-3937
Mailing Address - Fax:832-218-7162
Practice Address - Street 1:23108 SEVEN MEADOWS PKWY
Practice Address - Street 2:STE 250
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-0864
Practice Address - Country:US
Practice Address - Phone:281-371-3937
Practice Address - Fax:832-218-7162
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5830T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX612785Medicare PIN
TXV12237Medicare UPIN