Healthcare Provider Details

I. General information

NPI: 1689597346
Provider Name (Legal Business Name): MELINDA MONG-THUY DOAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5171 CITRUS BLVD
HARAHAN LA
70123-2342
US

IV. Provider business mailing address

160 NOEL DR
AVONDALE LA
70094-2964
US

V. Phone/Fax

Practice location:
  • Phone: 504-818-0669
  • Fax:
Mailing address:
  • Phone: 504-358-1781
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2084-031AT
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: