MEDICARE: HIEP DUONG O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	8468T	TX

General Provider Information

NPI Number	:	1043627904
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HIEP DUONG O.D.

Provider Business Mailing Address
First Line	:	1603 HACKNEY DR
Second Line	:
City	:	MANSFIELD
State	:	TX
Zip	:	76063-4262
Country	:	US
Telephone Number	:	214-729-7787
Fax Number	:

Provider Business Practice Location Address
First Line	:	5325 MCPHERSON BLVD STE 125
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76123-6028
Country	:	US
Telephone Number	:	817-935-8280
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2014
Last Update Date	:	03/29/2022

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