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General NPI Number Information
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NPI Number | 1326195595
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Entity Type | Individual
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Provider Name | QUYEN THUY DI HAMILTON O.D.
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Gender | Female
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 07/02/2009
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Provider Practice Location Address
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Address Line | 1601 VILLAGE PKWY STE 160
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City | LEWISVILLE
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State | TX
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Zip | 75077-3244
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Country | US
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Telephone | 972-317-0831
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Fax | 972-317-1360
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Provider Business Mailing Address
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Address Line | 1601 VILLAGE PKWY STE 160
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City | LEWISVILLE
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State | TX
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Zip | 75077-3244
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Country | US
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Telephone | 972-317-0831
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Fax | 972-317-1360
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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 | 6501TG
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License Number State | TX
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