MEDICARE: DR. BETTY THAO VINH O.D.

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	4889TG	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	81026Q	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1396968079
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BETTY THAO VINH O.D.

Provider Business Mailing Address
First Line	:	16303 CRETIAN POINT CT
Second Line	:
City	:	CYPRESS
State	:	TX
Zip	:	77429-6824
Country	:	US
Telephone Number	:	281-225-9334
Fax Number	:	281-225-9335

Provider Business Practice Location Address
First Line	:	8403 LOUETTA RD # 100
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77379-6737
Country	:	US
Telephone Number	:	832-717-7140
Fax Number	:	832-717-7142

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

Provider Enumeration Date	:	04/11/2007
Last Update Date	:	12/11/2013

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