Provider Demographics
NPI:1114037058
Name:GOPANI, TU-ANH NGUYEN (OD)
Entity Type:Individual
Prefix:DR
First Name:TU-ANH
Middle Name:NGUYEN
Last Name:GOPANI
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 1:331 KILLIAN RD
Mailing Address - Street 2:SUITE B2 EYE CONCEPTS LLC
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-8926
Mailing Address - Country:US
Mailing Address - Phone:803-754-8370
Mailing Address - Fax:803-759-8371
Practice Address - Street 1:331 KILLIAN RD
Practice Address - Street 2:B2 EYE CONCEPTS LLC
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-8926
Practice Address - Country:US
Practice Address - Phone:803-754-8370
Practice Address - Fax:803-759-8371
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1436152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
V03150Medicare UPIN