Provider Demographics
NPI:1992760490
Name:STEVE N. NGUYEN, O.D,, P.C.
Entity type:Organization
Organization Name:STEVE N. NGUYEN, O.D,, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:N
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:214-333-2020
Mailing Address - Street 1:2811 S HAMPTON RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75224-2329
Mailing Address - Country:US
Mailing Address - Phone:214-333-2020
Mailing Address - Fax:214-333-7316
Practice Address - Street 1:2811 S HAMPTON RD
Practice Address - Street 2:SUITE B
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75224-2329
Practice Address - Country:US
Practice Address - Phone:214-333-2020
Practice Address - Fax:214-333-7316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-18
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5438TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX213777001Medicaid
TX0A5439OtherMEDICARE PTAN
TX0A5439OtherMEDICARE PTAN
TXU67319Medicare UPIN