=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407106651
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THANH HUYNH OD PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/14/2012
-----------------------------------------------------
Last Update Date | 10/29/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 16535 SOUTHWEST FWY STE 230
-----------------------------------------------------
City | SUGAR LAND
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77479-2323
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-494-3435
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 16535 SOUTHWEST FWY STE 230
-----------------------------------------------------
City | SUGAR LAND
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77479-2323
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-494-3435
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | THANH T. HUYNH
-----------------------------------------------------
Credential | OD
-----------------------------------------------------
Telephone | 281-494-3435
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | 6676T
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------