Provider Demographics
NPI:1710872510
Name:NGUYEN, CHRISTELLE TUYET MINH (OD)
Entity type:Individual
Prefix:
First Name:CHRISTELLE
Middle Name:TUYET MINH
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 1:10320 BOULDER LN APT 722
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78726-1850
Mailing Address - Country:US
Mailing Address - Phone:571-623-1057
Mailing Address - Fax:
Practice Address - Street 1:651 N HIGHWAY 183 STE 265
Practice Address - Street 2:
Practice Address - City:LEANDER
Practice Address - State:TX
Practice Address - Zip Code:78641-7012
Practice Address - Country:US
Practice Address - Phone:512-980-6700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-11
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11432TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist