Healthcare Provider Details

I. General information

NPI: 1518051200
Provider Name (Legal Business Name): LYNDA M. DAO O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 12/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 S COOPER ST SUITE 737
ARLINGTON TX
76015-4196
US

IV. Provider business mailing address

4201 S COOPER ST SUITE 737
ARLINGTON TX
76015-4196
US

V. Phone/Fax

Practice location:
  • Phone: 817-419-8887
  • Fax: 800-551-9189
Mailing address:
  • Phone: 817-419-8887
  • Fax: 800-551-9189

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberTX6208TG
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: