Provider Demographics
NPI:1366739559
Name:NGUYEN, ANNY (OD)
Entity type:Individual
Prefix:
First Name:ANNY
Middle Name:
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 1:3460 W FM 544
Mailing Address - Street 2:SUITE 550
Mailing Address - City:WYLIE
Mailing Address - State:TX
Mailing Address - Zip Code:75098-9408
Mailing Address - Country:US
Mailing Address - Phone:972-429-3501
Mailing Address - Fax:972-442-4916
Practice Address - Street 1:3460 W FM 544
Practice Address - Street 2:SUITE 550
Practice Address - City:WYLIE
Practice Address - State:TX
Practice Address - Zip Code:75098-9408
Practice Address - Country:US
Practice Address - Phone:972-429-3501
Practice Address - Fax:972-442-4916
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-07
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7727T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist