1992805261 NPI number — DR. THUY-LAN DUONG NGUYEN O.D.

Table of content: DR. THUY-LAN DUONG NGUYEN O.D. (NPI 1992805261)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992805261 NPI number — DR. THUY-LAN DUONG NGUYEN O.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NGUYEN
Provider First Name:
THUY-LAN
Provider Middle Name:
DUONG
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
O.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1992805261
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/21/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1950 OLD GALLOWS RD
Provider Second Line Business Mailing Address:
STE 520
Provider Business Mailing Address City Name:
VIENNA
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22182-3970
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-847-8899
Provider Business Mailing Address Fax Number:
571-223-6780

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1732 N UNIVERSITY DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PEMBROKE PINES
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33024-3602
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-432-7711
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  OPC 0003695 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2925 . This is a "ADVANTICA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 2925 . This is a "OPTUM HEALTH" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 36018 . This is a "BLUE CROSS BLUE SHIELD FL" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 3645 . This is a "DAVIS VISION" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 2925 . This is a "VISION SERVICE PLAN (VSP)" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 2925 . This is a "SUPERIORVISION" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 57 . This is a "FLORIDA OPTOMETRIC PHYSICIAN NETWORK" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 2925 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 2925 . This is a "PREMIER EYE CARE/PREFERRED CARE PARTNERS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 5925 . This is a "AETNA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: FL0946 . This is a "EYEMED" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 2925 . This is a "HUMANA VISION" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 2925 . This is a "SAFEGUARD VISION" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 620759600 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2925 . This is a "CIGNA HEALTH PLANS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 5925 . This is a "TRICARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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