MEDICARE: DR. PING KUANG YEH 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	6494TG	TX

General Provider Information

NPI Number	:	1457393290
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PING KUANG YEH O.D.

Provider Business Mailing Address
First Line	:	1741 E BARDIN RD
Second Line	:	SUITE 291
City	:	ARLINGTON
State	:	TX
Zip	:	76018-4836
Country	:	US
Telephone Number	:	817-702-8470
Fax Number	:	817-702-8780

Provider Business Practice Location Address
First Line	:	1741 E BARDIN RD
Second Line	:	SUITE 291
City	:	ARLINGTON
State	:	TX
Zip	:	76018-4836
Country	:	US
Telephone Number	:	817-702-8470
Fax Number	:	817-702-8780

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

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	11/19/2013

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