Provider Demographics
NPI:1215964358
Name:NGUYEN, MONICA QUYNH (OD)
Entity type:Individual
Prefix:DR
First Name:MONICA
Middle Name:QUYNH
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:MONICA
Other - Middle Name:Q
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:2665 MARKET CENTER DR
Mailing Address - Street 2:STE 100
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-6563
Mailing Address - Country:US
Mailing Address - Phone:713-242-9050
Mailing Address - Fax:713-242-9096
Practice Address - Street 1:2665 MARKET CENTER DR STE 100
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-6563
Practice Address - Country:US
Practice Address - Phone:972-772-9659
Practice Address - Fax:972-772-3120
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-26
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6813T174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist