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General NPI Number Information
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NPI Number | 1871871657
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Entity Type | Individual
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Provider Name | DUYEN C XIN OD
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Gender | Female
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Dates
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Enumeration Date | 07/28/2011
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Last Update Date | 08/16/2018
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Provider Practice Location Address
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Address Line | 211 E BROADWAY
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City | ALTON
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State | IL
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Zip | 62002
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Country | US
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Telephone | 618-462-9818
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Fax | 314-741-4947
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Provider Business Mailing Address
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Address Line | 3750 GUNN HWY STE 108
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City | TAMPA
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State | FL
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Zip | 33618-8911
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Country | US
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Telephone | 813-712-0660
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Fax | 813-315-7900
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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 | 2011020321
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 046010493
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC5294
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License Number State | FL
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