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General NPI Number Information
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NPI Number | 1932581253
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Entity Type | Individual
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Provider Name | KIM TIEN BLOIS O.D.
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Gender | Female
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Dates
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Enumeration Date | 06/23/2015
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Last Update Date | 09/01/2015
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Provider Practice Location Address
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Address Line | 1800 W CHESTNUT ST STE 101
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City | DENTON
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State | TX
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Zip | 76201
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Country | US
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Telephone | 940-369-7441
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Fax | 940-369-7403
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Provider Business Mailing Address
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Address Line | 4308 KESTREL WAY
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City | CARROLLTON
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State | TX
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Zip | 75010-4683
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Country | US
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Telephone | 940-369-7441
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Fax | 940-369-7403
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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 | 8661TG
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License Number State | TX
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