MEDICARE: DR. BICHVAN NGOC HUYNH 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	5825T	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	760634860	OTHER	TX	TAX ID

General Provider Information

NPI Number	:	1811998586
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BICHVAN NGOC HUYNH O.D.

Provider Business Mailing Address
First Line	:	3917 SHAVER ST
Second Line	:
City	:	PASADENA
State	:	TX
Zip	:	77504-2603
Country	:	US
Telephone Number	:	713-941-6662
Fax Number	:	713-941-6665

Provider Business Practice Location Address
First Line	:	3917 SHAVER ST
Second Line	:
City	:	PASADENA
State	:	TX
Zip	:	77504-2603
Country	:	US
Telephone Number	:	713-941-6662
Fax Number	:	713-941-6665

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

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	05/02/2012

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