Provider Demographics
NPI:1386121168
Name:NGUYEN, ANGELINE (OD)
Entity type:Individual
Prefix:
First Name:ANGELINE
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 1:5900 COIT RD
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-5959
Mailing Address - Country:US
Mailing Address - Phone:972-985-1412
Mailing Address - Fax:972-767-4958
Practice Address - Street 1:5900 COIT RD
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-5959
Practice Address - Country:US
Practice Address - Phone:972-985-1412
Practice Address - Fax:972-767-4958
Is Sole Proprietor?:No
Enumeration Date:2018-07-24
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9417T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist