Individual provider Active NPI

Lan Thanh Nguyen, O.D.

  • Optometrist
  • Georgetown, TX
National Provider Identifier
1811146343
Registry record updated Jun 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7130 Issued in TX
Practice address
950 W University Ave
Ste 108
Georgetown, TX 78626
Phone
(512) 327-7000
NPI assigned
Sep 9, 2008
Last updated
Jun 7, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7130 TX Primary

Addresses

Primary practice location

950 W University Ave
Ste 108
Georgetown, TX 78626

Mailing address

5717 Balcones Dr
Austin, TX 78731-4203
Phone (512) 327-7000

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
I20140623000898 TX Practitioner - Optometry 8022232602 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifetime Vision Care Texas PLLCGroup PAC ID 2668783150, 2 clinicians

Practice addresses (Care Compare)

408 N Mays St
Round Rock, TX 78664-4317
Phone (512) 244-2003

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7130TXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Lifetime Vision Care Texas, PLLC Optometrist CurrentSince Nov 1, 2018 Accepting new patients
Lifetime Vision Care PA Optometrist PastSince Nov 1, 2018 Accepting new patients

Locations

408 N Mays St
Round Rock, TX 78664
Phone (512) 244-2003

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": "1220918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528329600000",
    "number": "1811146343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5717 BALCONES DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787314203",
            "telephone_number": "512-327-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 W UNIVERSITY AVE",
            "address_2": "STE 108",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "78626",
            "telephone_number": "512-327-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "LAN",
        "middle_name": "THANH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-09",
        "last_updated": "2018-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, TX

Sources for this page

Verify at the official NPI Registry.