Individual provider Active NPI

Kristin Diem Nguyen, OD

  • Optometrist
  • Dallas, TX
National Provider Identifier
1124865787
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10915T Issued in TX
Practice address
3636 McKinney Ave Ste 120
Dallas, TX 75204-1443
Phone
(214) 252-1800
Fax
(214) 252-1801
NPI assigned
Jul 11, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 10915T TX Primary

Addresses

Primary practice location

3636 McKinney Ave Ste 120
Dallas, TX 75204-1443

Mailing address

3636 McKinney Ave Ste 120
Dallas, TX 75204-1443
Phone (214) 252-1800

Other practice location 1

5330 E Mockingbird Ln Ste 130
Dallas, TX 75206-0961
Phone (214) 341-9955

Other practice location 2

7324 Gaston Ave # 310
Dallas, TX 75214-6126
Phone (214) 660-9830

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
I20250127000306 TX Practitioner - Optometry 4284163924 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aeg Texas Professional PLLCGroup PAC ID 4486985678, 228 clinicians

Practice addresses (Care Compare)

6850 N Shiloh Rd
Suite T
Garland, TX 75044-2918
Phone (972) 414-5663

7324 Gaston Ave
Suite 310
Dallas, TX 75214-6126
Phone (214) 660-9830

8611 Hillcrest Ave
Suite 140
Dallas, TX 75225-4217
Phone (214) 739-8611

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10915TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Aeg Texas Professional PLLC Optometrist CurrentSince Jan 5, 2025 Accepting new patients
Janet B Ogletree OD PA Optometrist PastSince Nov 1, 2016 Accepting new patients
Dianne Bui Dao OD PC Optometrist PastSince Apr 24, 2011 Accepting new patients

Locations

111 E 4th St
Ste 440
Alton, IL 62002

12320 Barker Cypress Rd
Ste 400
Cypress, TX 77429
Phone (281) 373-1020

5330 E Mockingbird Ln
Ste 130
Dallas, TX 75206
Phone (214) 341-9955

7324 Gaston Ave
#310
Dallas, TX 75214
Phone (214) 660-9830

3636 McKinney Ave
Ste 120
Dallas, TX 75204
Phone (214) 252-1800

6500 Greenville Ave
Ste 150
Dallas, TX 75206
Phone (214) 692-1901

3551 Justin Rd
Ste 150
Flower Mound, TX 75028
Phone (210) 490-9205

6850 N Shiloh Rd
Ste T
Garland, TX 75044
Phone (972) 414-0444

2705 Broadway St
Ste 115
Pearland, TX 77581
Phone (281) 485-2020

670 E Southlake Blvd
Southlake, TX 76092
Phone (817) 329-6466

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1720656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765929600000",
    "number": "1124865787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3636 MCKINNEY AVE STE 120",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752041443",
            "telephone_number": "214-252-1800",
            "fax_number": "214-252-1801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3636 MCKINNEY AVE STE 120",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752041443",
            "telephone_number": "214-252-1800",
            "fax_number": "214-252-1801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5330 E Mockingbird Ln Ste 130",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752060961",
            "country_code": "US",
            "telephone_number": "214-341-9955",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7324 Gaston Ave # 310",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752146126",
            "country_code": "US",
            "telephone_number": "214-660-9830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "KRISTIN",
        "middle_name": "DIEM",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-11",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "10915T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.