Individual provider Active NPI

Tyler T Nguyen, O.D.

  • Optometrist
  • Fort Worth, TX
National Provider Identifier
1003280017
Registry record updated Nov 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8758T Issued in TX
Practice address
2720 Western Center Blvd
Suite 316
Fort Worth, TX 76131-4302
Phone
(817) 847-9000
NPI assigned
Nov 15, 2015
Last updated
Nov 15, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 8758T TX Primary

Addresses

Primary practice location

2720 Western Center Blvd
Suite 316
Fort Worth, TX 76131-4302

Mailing address

2720 Western Center Blvd
Suite 316
Fort Worth, TX 76131-4302
Phone (817) 847-9000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160414001372 TX Practitioner - Optometry 0345548913 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8758TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Tran Vision Associates, PLLC Optometrist CurrentSince Mar 22, 2016 Accepting new patients
Vision Depot LLC Optometrist PastSince Sep 23, 2013 Accepting new patients

Locations

2720 Western Center Blvd
Ste 316
Fort Worth, TX 76131
Phone (817) 847-9000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/27041/brand/1/csg/1/fhir/r4

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1447545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447545600000",
    "number": "1003280017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2720 WESTERN CENTER BLVD",
            "address_2": "SUITE 316",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761314302",
            "telephone_number": "817-847-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 WESTERN CENTER BLVD",
            "address_2": "SUITE 316",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761314302",
            "telephone_number": "817-847-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "TYLER",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-11-15",
        "last_updated": "2015-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8758T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.