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NPI Code Detail

MEDICARE: DR. LINDA M CHOUS OD

MEDICARE: DR. LINDA M CHOUS OD
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
1152W00000XOptometrist2219MN

General Provider Information

NPI Number : 1205814134
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LINDA M CHOUS OD
Provider Business Mailing Address
First Line : 3142 HENNEPIN AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55408-2619
Country : US
Telephone Number : 612-822-7021
Fax Number : 612-822-6123
Provider Business Practice Location Address
First Line : 3142 HENNEPIN AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55408-2619
Country : US
Telephone Number : 612-822-7021
Fax Number : 612-822-6123
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/30/2005
Last Update Date : 07/08/2007

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