Provider Demographics
NPI:1275941874
Name:HUYNH, AN TAM (OD)
Entity Type:Individual
Prefix:DR
First Name:AN
Middle Name:TAM
Last Name:HUYNH
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:AN TAM
Other - Middle Name:
Other - Last Name:HUYNH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:3324 W UNIVERSITY AVE STE A
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-2540
Mailing Address - Country:US
Mailing Address - Phone:352-240-0801
Mailing Address - Fax:
Practice Address - Street 1:3324 W UNIVERSITY AVE STE A
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-2540
Practice Address - Country:US
Practice Address - Phone:352-240-0801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-27
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8577T152W00000X
FL5474152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist