Individual provider Active NPI

Van Kim Nguyen, O.D.

  • Optometrist
  • Houston, TX
National Provider Identifier
1477967347
Registry record updated Oct 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8411T Issued in TX
Practice address
805 Walker St
Houston, TX 77002-5715
Phone
(713) 654-0042
Fax
(713) 654-7123
NPI assigned
Jun 18, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 8411T TX Primary

Addresses

Primary practice location

805 Walker St
Houston, TX 77002-5715

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970
Phone (703) 847-8899

Other practice location 1

1250 Uvalde Rd
Houston, TX 77015-3708
Phone (713) 453-2972

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
I20140911001052 TX Practitioner - Optometry 1850510579 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8411TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Med Southwest, PLLC Optometrist CurrentSince Nov 22, 2021 Accepting new patients
Med Southwest, PLLC Optometrist CurrentSince Nov 22, 2021 Accepting new patients
Med Southwest, PLLC Optometrist Current Accepting new patients
Silver Spring Optometry, LLC Optometrist Past Accepting new patients

Locations

6127 FM 1960 Rd W
Houston, TX 77069
Phone (281) 469-2020

4400 North Fwy
Ste B300
Houston, TX 77022
Phone (713) 697-2081

1051 Halsey St
Ste A
Houston, TX 77015
Phone (269) 808-7552

805 Walker St
Houston, TX 77002
Phone (713) 654-0042

3405 Spencer Hwy
Pasadena, TX 77504
Phone (713) 946-9300

2703 Richmond Rd
Texarkana, TX 75503
Phone (903) 838-0783

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 4

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": "1403049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635465600000",
    "number": "1477967347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 WALKER ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770025715",
            "telephone_number": "713-654-0042",
            "fax_number": "713-654-7123"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1250 Uvalde Rd",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770153708",
            "country_code": "US",
            "telephone_number": "713-453-2972",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "VAN",
        "middle_name": "KIM",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-18",
        "last_updated": "2021-10-29",
        "certification_date": "2021-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8411T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.