Kim-Dan Phan Nguyen, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

8429T Issued in TX

Practice address

17202 Clay Rd
Suite 102
Houston, TX 77084-4291

Phone

(281) 886-7063

NPI assigned

Jul 15, 2014

Last updated

Jun 5, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Eyecare Leaders PA

  • Optometrist
  • Houston, TX
  • NPI 1790893238
  Medicare reassignment NPD

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

{
    "created_epoch": "1405382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433462400000",
    "number": "1326455007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17202 CLAY RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770844291",
            "telephone_number": "281-886-7063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17202 CLAY RD",
            "address_2": "SUITE 102",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770844291",
            "telephone_number": "281-886-7063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "KIM-DAN",
        "middle_name": "PHAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-15",
        "last_updated": "2015-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8429T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kim Hoang Nguyen, D.D.S.
• Kim Loan Nguyen, DDS
• Kim Mai Nguyen, O.D.
• Kim Sang Thi Nguyen, PHARMD
• Kim Xuan Thi Nguyen, D.C.
• Kim-Phuong Thi Nguyen, M.D.
• Kimanh Nguyen
• Kimberly Minh Chau Nguyen
• Kimberly Quynh-Thanh Nguyen, MD
• Kimberly Thien Nguyen, PHARMD

• Optometrist in Houston, TX
• Providers in Houston, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.