Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 4693T | TX |
NPI | 1013064609 |
---|---|
Provider Name | Dr. Mary C Nguyen |
First Address | Arlington, TX 76015-6293 |
Second Address | Arlington, TX 76015-4107 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2007 |
Last Update Date | 08/07/2007 |