Provider Demographics
NPI:1023359650
Name:HOANG, KAYLA HONG (OD)
Entity Type:Individual
Prefix:DR
First Name:KAYLA
Middle Name:HONG
Last Name:HOANG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 N PLANO RD
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-3827
Mailing Address - Country:US
Mailing Address - Phone:503-419-7033
Mailing Address - Fax:
Practice Address - Street 1:159 N PLANO RD
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-3827
Practice Address - Country:US
Practice Address - Phone:469-567-3640
Practice Address - Fax:469-567-3737
Is Sole Proprietor?:No
Enumeration Date:2013-03-06
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8140TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4338634-01Medicaid