Provider Demographics
NPI:1407394067
Name:ANNY NGUYEN O.D. PLLC
Entity type:Organization
Organization Name:ANNY NGUYEN O.D. PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:ANNY
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:469-585-4398
Mailing Address - Street 1:3460 W FM 544 STE 550
Mailing Address - Street 2:
Mailing Address - City:WYLIE
Mailing Address - State:TX
Mailing Address - Zip Code:75098-9408
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7805 N MACARTHUR BLVD STE 101
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-7531
Practice Address - Country:US
Practice Address - Phone:972-496-0839
Practice Address - Fax:214-496-0841
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANNY NGUYEN O.D.PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-02-03
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7727TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty