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General NPI Number Information
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NPI Number | 1457535163
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Entity Type | Individual
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Provider Name | KIM CHI THI TRINH O.D.
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Gender | Female
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Dates
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Enumeration Date | 12/18/2007
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Last Update Date | 01/16/2008
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Provider Practice Location Address
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Address Line | 9616 N LAMAR BLVD STE 159
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City | AUSTIN
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State | TX
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Zip | 78753-4150
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Country | US
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Telephone | 512-835-9226
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Fax | 512-835-7413
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Provider Business Mailing Address
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Address Line | 1753 GAYLORD DR
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City | AUSTIN
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State | TX
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Zip | 78728-5750
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Country | US
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Telephone | 512-797-8071
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Fax | 512-835-7413
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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 | 6997T
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License Number State | TX
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