Individual provider Active NPI

Jessica U Nguyen, O.D.

  • Optometrist
  • Mesquite, TX
National Provider Identifier
1235153933
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6948TG Issued in TX
Practice address
2124 Town East Mall
Mesquite, TX 75150
Phone
(972) 613-3581
Fax
(972) 279-1829
NPI assigned
Jul 26, 2006
Last updated
Jun 21, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6948TG TX Primary

Addresses

Primary practice location

2124 Town East Mall
Mesquite, TX 75150

Mailing address

2124 Town East Mall
Mesquite, TX 75150-4119
Phone (972) 613-3581

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
I20061108000125 TX Practitioner - Optometry 9032116934 Practice locations: Mesquite, TX

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6948TGTXMDOptometrist

Organizations & group practices 1

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529539200000",
    "number": "1235153933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2124 TOWN EAST MALL",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751504119",
            "telephone_number": "972-613-3581",
            "fax_number": "972-279-1829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2124 TOWN EAST MALL",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "75150",
            "telephone_number": "972-613-3581",
            "fax_number": "972-279-1829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "JESSICA",
        "middle_name": "U",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2018-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6948TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesquite, TX

Sources for this page

Verify at the official NPI Registry.