Active NPI
Kimberly Nguyen, O.D.
- Optometrist
- Garland, TX
National Provider Identifier
1386790244
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 5741TG
- Practice address
- 3575 W Walnut St
C
Garland, TX 75042-6208 - Phone
- (972) 272-9455
- NPI assigned
- Jan 25, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 5741TG | TX | Primary |
Addresses
Primary practice location
3575 W Walnut St
C
Garland, TX 75042-6208
Mailing address
3575 W Walnut St
C
Garland, TX 75042-6208
Phone (972) 272-9455
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| TX5741 | Other | TX | EYEMED |
| 11585 | Other | TX | SPECTERA GROUP ID |
| 918178 | Other | TX | BLOCK MANAGED MEDICAID |
| 041927701 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5741TG | TX | MD | Optometrist |
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 and National Provider Directory roles.
-
- Optometrist
- Lake Charles, LA
- NPI 1295769008
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1370390400000",
"number": "1386790244",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3575 W WALNUT ST",
"address_2": "C",
"city": "GARLAND",
"state": "TX",
"postal_code": "750426208",
"telephone_number": "972-272-9455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3575 W WALNUT ST",
"address_2": "C",
"city": "GARLAND",
"state": "TX",
"postal_code": "750426208",
"telephone_number": "972-272-9455"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "KIMBERLY",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-25",
"last_updated": "2013-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "5741TG",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EYEMED",
"identifier": "TX5741",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SPECTERA GROUP ID",
"identifier": "11585",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLOCK MANAGED MEDICAID",
"identifier": "918178",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "041927701",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Garland, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2013; 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.