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General NPI Number Information
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NPI Number | 1083179600
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Entity Type | Individual
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Provider Name | JOSEPH KHANG VU OD
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Gender | Male
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Dates
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Enumeration Date | 02/07/2019
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Last Update Date | 02/28/2026
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Provider Practice Location Address
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Address Line | 4101 HIGHWAY 121 STE 100
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City | BEDFORD
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State | TX
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Zip | 76021-3053
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Country | US
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Telephone | 817-494-3049
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Fax | 817-725-7030
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Provider Business Mailing Address
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Address Line | 4101 HIGHWAY 121 STE 100
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City | BEDFORD
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State | TX
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Zip | 76021-3053
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Country | US
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Telephone | 817-494-3049
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Fax | 817-725-7030
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 9629
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License Number State | TX
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