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General NPI Number Information
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NPI Number | 1124516927
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Entity Type | Organization
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Legal Business Name | HOANG SQUARED
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Dates
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Enumeration Date | 04/26/2018
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Last Update Date | 06/11/2018
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Provider Practice Location Address
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Address Line | 11020 HARLEM RD STE 800
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City | RICHMOND
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State | TX
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Zip | 77406
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Country | US
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Telephone | 832-212-2701
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Fax |
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Provider Business Mailing Address
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Address Line | 209 PALMER ST
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City | HOUSTON
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State | TX
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Zip | 77003-2303
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Country | US
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Telephone | 832-212-2701
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Fax |
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Authorized Official
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Title or Position | OWNER, OPTOMETRIST
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Name | DR. MINA BAO HOANG
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Credential | OD
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Telephone | 832-212-2701
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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 | 7762TG
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License Number State | TX
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