Provider Demographics
NPI:1063548089
Name:KARA C. NGUYEN OD PA
Entity type:Organization
Organization Name:KARA C. NGUYEN OD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KARA
Authorized Official - Middle Name:C
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:817-926-6000
Mailing Address - Street 1:2832 S HULEN ST
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76109-1514
Mailing Address - Country:US
Mailing Address - Phone:917-926-6000
Mailing Address - Fax:817-921-9429
Practice Address - Street 1:2832 S HULEN ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76109-1514
Practice Address - Country:US
Practice Address - Phone:917-926-6046
Practice Address - Fax:817-921-9429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier