Provider Demographics
NPI:1871846634
Name:DOAN, JENNIFER NGUYEN (OD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:NGUYEN
Last Name:DOAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4106 COLLEGE DR.
Mailing Address - Street 2:#110
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75901
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2206 N JOHN REDDITT DR
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-1776
Practice Address - Country:US
Practice Address - Phone:936-671-4300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-17
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM649152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist