Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 5349T | TX |
NPI | 1255302477 |
---|---|
Provider Name | Dr. Diana Thi Nguyen |
First Address | Plano, TX 75025-3947 |
Second Address | Dallas, TX 75238-3275 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2006 |
Last Update Date | 02/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
093004202 | (05) | TX |