Provider Demographics
NPI:1063863454
Name:NGUYEN, VICKI THUY VY (OD)
Entity type:Individual
Prefix:DR
First Name:VICKI
Middle Name:THUY VY
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 HIGHWAY 287 N
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063
Mailing Address - Country:US
Mailing Address - Phone:682-518-1177
Mailing Address - Fax:682-518-8889
Practice Address - Street 1:1650 HIGHWAY 287 N
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-8852
Practice Address - Country:US
Practice Address - Phone:682-518-1177
Practice Address - Fax:682-518-8889
Is Sole Proprietor?:No
Enumeration Date:2016-06-27
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9036T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist