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NPI Code Detail

MEDICARE: KAYLA H DAO O.D.

MEDICARE: KAYLA H 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
1152W00000XOptometrist7370TGTX
2152WP0200XPediatric Optometrist7370TGTX
3152WV0400XVision Therapy Optometrist7370TGTX

General Provider Information

NPI Number : 1649506981
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLA H DAO O.D.
Provider Business Mailing Address
First Line : 11402 PINE KNOLL DR
Second Line :
City : HOUSTON
State : TX
Zip : 77099-2610
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 121 HIGHWAY 332 W
Second Line : SUITE 100
City : LAKE JACKSON
State : TX
Zip : 77566-4028
Country : US
Telephone Number : 979-480-9424
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/21/2009
Last Update Date : 10/21/2009

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