MEDICARE: DR. TRANG DAO 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	6927	TX
2	152W00000X	Optometrist	6927TG	TX

General Provider Information

NPI Number	:	1609980929
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TRANG DAO O.D.

Provider Business Mailing Address
First Line	:	4800 S HULEN ST
Second Line	:	STE 2720
City	:	FORT WORTH
State	:	TX
Zip	:	76132
Country	:	US
Telephone Number	:	817-346-2186
Fax Number	:	817-370-7902

Provider Business Practice Location Address
First Line	:	4800 S HULEN ST STE 2720
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76132-1465
Country	:	US
Telephone Number	:	817-346-2186
Fax Number	:

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

Provider Enumeration Date	:	08/17/2006
Last Update Date	:	03/17/2018

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