Provider Demographics
NPI:1013043124
Name:HUEY AND HSIAO OPTOMETRIC CORPORATION
Entity Type:Organization
Organization Name:HUEY AND HSIAO OPTOMETRIC CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:HUEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:707-437-9600
Mailing Address - Street 1:301 DICKSON HILL RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-7203
Mailing Address - Country:US
Mailing Address - Phone:707-437-9600
Mailing Address - Fax:707-421-9331
Practice Address - Street 1:301 DICKSON HILL RD
Practice Address - Street 2:SUITE B
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-7203
Practice Address - Country:US
Practice Address - Phone:707-437-9600
Practice Address - Fax:707-421-9331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-25
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ29704ZMedicare PIN