Provider Demographics
NPI:1457457491
Name:VU, SUMMER PHAN (OD)
Entity Type:Individual
Prefix:DR
First Name:SUMMER
Middle Name:PHAN
Last Name:VU
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5540 CLAY CT
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-0704
Mailing Address - Country:US
Mailing Address - Phone:817-557-8910
Mailing Address - Fax:817-557-8232
Practice Address - Street 1:600 W ARBROOK BLVD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-3702
Practice Address - Country:US
Practice Address - Phone:817-557-8910
Practice Address - Fax:817-557-8232
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6806TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist