MEDICARE: JUDY JANE XU OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	11463TG	TX

General Provider Information

NPI Number	:	1306735576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUDY JANE XU OD

Provider Business Mailing Address
First Line	:	1920 PARKER RD STE 120
Second Line	:
City	:	CARROLLTON
State	:	TX
Zip	:	75010-4864
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1920 PARKER RD
Second Line	:
City	:	CARROLLTON
State	:	TX
Zip	:	75010-4859
Country	:	US
Telephone Number	:	972-939-5367
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2025
Last Update Date	:	08/12/2025

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