Individual provider Active NPI

Jason Ngoc Lam Nguyen, O.D.

  • Optometrist
  • Katy, TX
National Provider Identifier
1629373857
Registry record updated Mar 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7413TG Issued in TX
Practice address
6501 S Fry Rd
Ste 100B
Katy, TX 77494-3376
Phone
(281) 392-5033
NPI assigned
Jan 19, 2011
Last updated
Mar 4, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 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 7413TG TX Primary

Addresses

Primary practice location

6501 S Fry Rd
Ste 100B
Katy, TX 77494-3376

Mailing address

6501 S Fry Rd
Ste 100-B
Katy, TX 77494-3376
Phone (281) 991-3937

Other identifiers 1

IdentifierTypeStateIssuer
7413TGOtherTXOPTOMETRY LICENSE

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
I20121029000296 TX Practitioner - Optometry 7113177189

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Vu Ky Nguyen, O.D., P.a. Optometrist Past Accepting new patients

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, 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": "1295395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1629373857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6501 S FRY RD",
            "address_2": "STE 100-B",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774943376",
            "telephone_number": "281-991-3937",
            "fax_number": "281-991-6836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6501 S FRY RD",
            "address_2": "STE 100B",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774943376",
            "telephone_number": "281-392-5033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "JASON",
        "middle_name": "NGOC LAM",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-19",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7413TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTOMETRY LICENSE",
            "identifier": "7413TG",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

Verify at the official NPI Registry.