MEDICARE: MRS. LONI LANANH HOANG 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	7493T	TX

General Provider Information

NPI Number	:	1760532568
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LONI LANANH HOANG O.D.

Provider Business Mailing Address
First Line	:	3725 FOSSILWOOD WAY
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78681-2348
Country	:	US
Telephone Number	:	714-292-3926
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 WALTON WAY STE 102
Second Line	:
City	:	CEDAR PARK
State	:	TX
Zip	:	78613-7017
Country	:	US
Telephone Number	:	512-259-7104
Fax Number	:	512-259-7063

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

Provider Enumeration Date	:	01/12/2007
Last Update Date	:	07/08/2014

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