Individual
EMILY TRANG NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
4025 JACKIE RD SE, RIO RANCHO, NM 87124-6610
(505) 892-8411
(505) 891-5497
Mailing address
4025 JACKIE RD SE, RIO RANCHO, NM 87124-6610
(505) 892-8411
(505) 891-5497
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
561
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
152W00000X
—
NM
01
—
NM0561
EYE MED
NM
01
—
OP2561
LICENSE #
NM
Enumeration date
12/11/2006
Last updated
12/08/2010
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