Healthcare Provider Details

I. General information

NPI: 1811147150
Provider Name (Legal Business Name): MISA TRANG HUYNH, O.D. P.A
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2008
Last Update Date: 09/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5141 FM 1960 RD W
HOUSTON TX
77069-4504
US

IV. Provider business mailing address

5141 FM 1960 RD W
HOUSTON TX
77069-4504
US

V. Phone/Fax

Practice location:
  • Phone: 281-583-7070
  • Fax: 281-583-1117
Mailing address:
  • Phone: 281-583-7070
  • Fax: 281-583-1117

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number5352TG
License Number StateTX

VIII. Authorized Official

Name: DR. SANH CAO DINH
Title or Position: VICE PRESIDENT
Credential: O.D.
Phone: 281-583-7070