MEDICARE: DR. WENDY WANYIN HO 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	5571T	TX

General Provider Information

NPI Number	:	1225056211
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WENDY WANYIN HO O.D.

Provider Business Mailing Address
First Line	:	3012 GLEN MEADOW DR
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75025-5271
Country	:	US
Telephone Number	:	214-769-9843
Fax Number	:

Provider Business Practice Location Address
First Line	:	4909 W PARK BLVD
Second Line	:	SUITE 135
City	:	PLANO
State	:	TX
Zip	:	75093-2311
Country	:	US
Telephone Number	:	972-985-7916
Fax Number	:

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

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	07/08/2007

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