Most Relevant Information
Provider Data
| NPI Number: | 1003536749 |
| Provider Name: | KIM NGUYEN OD |
| Entity Type: | Individual |
| Taxonomy Code: | 152W00000X |
| Specialty: | Optometrist |
| License Number: | 009630 |
Most Important Dates
| Enumeration Date: | 09/01/2022 |
| Last Updated: | 10/14/2024 |
Provider Practice Location
5572 AVERY DR
MARRERO
LA
700725138
Practice Location Phone/Fax
| Phone: | 5042141627 |
| Fax: |
Provider Mailing Location
5572 AVERY DR
MARRERO
LA
700725138
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |