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General NPI Number Information
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NPI Number | 1467176552
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Entity Type | Organization
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Legal Business Name | DOAN GROUP
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Dates
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Enumeration Date | 10/03/2022
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Last Update Date | 12/08/2022
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Provider Practice Location Address
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Address Line | 2101 HARWOOD RD STE 126
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City | BEDFORD
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State | TX
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Zip | 76021-4700
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Country | US
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Telephone | 682-583-7082
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Fax |
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Provider Business Mailing Address
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Address Line | 2101 HARWOOD RD STE 126
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City | BEDFORD
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State | TX
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Zip | 76021-4700
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Country | US
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Telephone | 682-583-7082
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | TAVIA THO-KIM DOAN
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Credential | O.D.
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Telephone | 682-583-7082
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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 |
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License Number State |
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