Provider Demographics
NPI:1427066398
Name:NGUYEN, ROBERT T (OD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:T
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7312 LOUETTA RD
Mailing Address - Street 2:SUITE B-116
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-6175
Mailing Address - Country:US
Mailing Address - Phone:832-717-0900
Mailing Address - Fax:832-717-0908
Practice Address - Street 1:7312 LOUETTA RD
Practice Address - Street 2:SUITE B-116
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-6175
Practice Address - Country:US
Practice Address - Phone:832-717-0900
Practice Address - Fax:832-717-0908
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2013-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6459TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX177201401Medicaid
TX8C7940Medicare ID - Type Unspecified
TX177201401Medicaid