Provider Demographics
NPI:1992805261
Name:NGUYEN, THUY-LAN DUONG (OD)
Entity type:Individual
Prefix:DR
First Name:THUY-LAN
Middle Name:DUONG
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 1:1950 OLD GALLOWS RD
Mailing Address - Street 2:STE 520
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3970
Mailing Address - Country:US
Mailing Address - Phone:703-847-8899
Mailing Address - Fax:571-223-6780
Practice Address - Street 1:1732 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-3602
Practice Address - Country:US
Practice Address - Phone:954-432-7711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 0003695152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2925OtherADVANTICA
FL2925OtherOPTUM HEALTH
FL36018OtherBLUE CROSS BLUE SHIELD FL
FL3645OtherDAVIS VISION
FL2925OtherVISION SERVICE PLAN (VSP)
FL2925OtherSUPERIORVISION
FL57OtherFLORIDA OPTOMETRIC PHYSICIAN NETWORK
FL2925OtherUNITED HEALTH CARE
FL2925OtherPREMIER EYE CARE/PREFERRED CARE PARTNERS
FL5925OtherAETNA
FLFL0946OtherEYEMED
FL2925OtherHUMANA VISION
FL2925OtherSAFEGUARD VISION
FL620759600Medicaid
FL2925OtherCIGNA HEALTH PLANS
FL5925OtherTRICARE
FL2925OtherADVANTICA
FL5925OtherTRICARE