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NPI Code Detail

MEDICARE: DR. HA TRIEU OD

MEDICARE: DR. HA TRIEU 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
1152WC0802XCorneal and Contact Management Optometrist5671TTX

General Provider Information

NPI Number : 1356494694
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HA TRIEU OD
Provider Business Mailing Address
First Line : 11509 ROYSTON ST
Second Line :
City : FORT WORTH
State : TX
Zip : 76244-2539
Country : US
Telephone Number : 817-680-4256
Fax Number :
Provider Business Practice Location Address
First Line : 8520 N BEACH ST
Second Line :
City : FORT WORTH
State : TX
Zip : 76244-4918
Country : US
Telephone Number : 817-503-9798
Fax Number : 817-503-9781
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2007
Last Update Date : 10/27/2023

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