Provider Demographics
NPI:1881814226
Name:NGUYEN, STEVE (OD)
Entity type:Individual
Prefix:DR
First Name:STEVE
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2260 VILLAGE WALK DRIVE
Mailing Address - Street 2:SUITE 108
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052
Mailing Address - Country:US
Mailing Address - Phone:702-871-3937
Mailing Address - Fax:702-871-3936
Practice Address - Street 1:2260 VILLAGE WALK DRIVE
Practice Address - Street 2:SUITE 108
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052
Practice Address - Country:US
Practice Address - Phone:702-871-3937
Practice Address - Fax:702-871-3936
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV417152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV36467Medicare ID - Type Unspecified