MEDICARE: DR. PHILLIP T DOAN 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
1	152WV0400X	Vision Therapy Optometrist	5657TG	TX
2	152W00000X	Optometrist	5657TG	TX

General Provider Information

NPI Number	:	1497756571
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PHILLIP T DOAN OD

Provider Business Mailing Address
First Line	:	8710 GRAND MISSION BLVD STE D
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77407-5413
Country	:	US
Telephone Number	:	281-603-1777
Fax Number	:

Provider Business Practice Location Address
First Line	:	8710 GRAND MISSION BLVD STE D
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77407-5413
Country	:	US
Telephone Number	:	281-603-1777
Fax Number	:

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

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	10/15/2024

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