Provider Demographics
NPI:1225190093
Name:KUO, DAVID (OD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:KUO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2013 FLOYD AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23220-4544
Mailing Address - Country:US
Mailing Address - Phone:804-651-9205
Mailing Address - Fax:
Practice Address - Street 1:1404 N PARHAM RD
Practice Address - Street 2:SUITE N02
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-5533
Practice Address - Country:US
Practice Address - Phone:804-740-4372
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2007-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618001522152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist