MEDICARE: DR. SONIA TAN 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	13462T	CA
2	152W00000X	Optometrist	8818T	TX

General Provider Information

NPI Number	:	1427217538
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SONIA TAN O.D.

Provider Business Mailing Address
First Line	:	7845 N MACARTHUR BLVD
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75063-7516
Country	:	US
Telephone Number	:	469-420-9368
Fax Number	:

Provider Business Practice Location Address
First Line	:	7845 N MACARTHUR BLVD
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75063-7516
Country	:	US
Telephone Number	:	469-420-9368
Fax Number	:

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

Provider Enumeration Date	:	06/04/2008
Last Update Date	:	10/12/2019

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Directions to “ DR. SONIA TAN O.D.” Practice Location

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