Provider Demographics
NPI:1063691418
Name:BAO-TRAN NGUYEN O.D P.A.
Entity type:Organization
Organization Name:BAO-TRAN NGUYEN O.D P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BAO-TRAN
Authorized Official - Middle Name:DINH
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:281-248-4565
Mailing Address - Street 1:455 GREENSPOINT MALL
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77060-1815
Mailing Address - Country:US
Mailing Address - Phone:281-248-4565
Mailing Address - Fax:281-248-4472
Practice Address - Street 1:455 GREENSPOINT MALL
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-1815
Practice Address - Country:US
Practice Address - Phone:281-248-4565
Practice Address - Fax:281-248-4472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-01
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6235152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty