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Individual

DR. KIMBERLY NGUYEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
3575 W WALNUT ST, C, GARLAND, TX 75042-6208
(972) 272-9455
Mailing address
3575 W WALNUT ST, C, GARLAND, TX 75042-6208
(972) 272-9455

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5741TG
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
041927701
TX
01
11585
SPECTERA GROUP ID
TX
01
918178
BLOCK MANAGED MEDICAID
TX
01
TX5741
EYEMED
TX
Enumeration date
01/25/2007
Last updated
06/05/2013
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