MEDICARE: DR. HAN NGOC VO 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	5502T	TX

General Provider Information

NPI Number	:	1427186055
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HAN NGOC VO O.D.

Provider Business Mailing Address
First Line	:	7827 PIRATE POINT CIR
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76016-5342
Country	:	US
Telephone Number	:	817-478-6022
Fax Number	:

Provider Business Practice Location Address
First Line	:	1712 N BEACH ST
Second Line	:
City	:	HALTOM CITY
State	:	TX
Zip	:	76111-6618
Country	:	US
Telephone Number	:	817-222-2020
Fax Number	:	817-222-2020

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

Provider Enumeration Date	:	03/02/2007
Last Update Date	:	07/08/2007

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