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NPI Code Detail

MEDICARE: MEGAN THU PHU OD

MEDICARE: MEGAN THU PHU 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
1152W00000XOptometrist11376TX

General Provider Information

NPI Number : 1700679065
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGAN THU PHU OD
Provider Business Mailing Address
First Line : 111 E 4TH ST STE 440
Second Line :
City : ALTON
State : IL
Zip : 62002-6206
Country : US
Telephone Number : 618-462-9818
Fax Number :
Provider Business Practice Location Address
First Line : 3908 FAR WEST BLVD
Second Line :
City : AUSTIN
State : TX
Zip : 78731-2994
Country : US
Telephone Number : 512-343-0432
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2025
Last Update Date : 05/29/2025

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Directions to “ MEGAN THU PHU OD” Practice Location

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