Individual provider Active NPI

Mai Nguyen, O.D.

  • Optometrist
  • Dallas, TX
National Provider Identifier
1356699276
Registry record updated May 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7947TG Issued in TX
Practice address
6243 Retail Rd
Ste 800
Dallas, TX 75231
Phone
(214) 890-9864
Fax
(214) 360-7738
NPI assigned
Aug 27, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7947T TX
Optometrist 152W00000X 7947TG TX Primary

Addresses

Primary practice location

6243 Retail Rd
Ste 800
Dallas, TX 75231

Mailing address

6243 Retail Rd
Ste 800
Dallas, TX 75231
Phone (214) 890-9864

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
I20130808000437 TX Practitioner - Optometry 3072755743 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12835 Preston Rd
Suite 218
Dallas, TX 75230-1277
Phone (214) 890-9864

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7947TXMDBehavioral Analyst
7947TTXMDOptometrist
7947TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eyes on Dallas PLLC Optometrist CurrentSince Oct 23, 2021 Accepting new patients
Mai Nguyen OD PLLC Optometrist CurrentSince May 21, 2013 Accepting new patients

Locations

6243 Retail Rd
Ste 800
Dallas, TX 75231
Phone (214) 750-4261

12835 Preston Rd
Ste 218
Dallas, TX 75230
Phone (214) 890-9864

6243 Retail Rd
#800B
Dallas, TX 75231
Phone (214) 890-9864

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1346025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590710400000",
    "number": "1356699276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6243 RETAIL RD",
            "address_2": "STE 800",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75231",
            "telephone_number": "214-890-9864",
            "fax_number": "214-360-7738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6243 RETAIL RD",
            "address_2": "STE 800",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75231",
            "telephone_number": "214-890-9864",
            "fax_number": "214-360-7738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "MAI",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-27",
        "last_updated": "2020-05-29",
        "certification_date": "2020-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7947T",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7947TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.