Provider Demographics
NPI:1477616357
Name:DAHU, JOHN F (OD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:F
Last Name:DAHU
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 1:11103 WEST AVE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213-1370
Mailing Address - Country:US
Mailing Address - Phone:210-524-6803
Mailing Address - Fax:210-524-6587
Practice Address - Street 1:7611 W THOMAS RD
Practice Address - Street 2:SUITE B 018
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85033-5433
Practice Address - Country:US
Practice Address - Phone:623-873-2511
Practice Address - Fax:623-849-9459
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2014-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1453152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZV06815Medicare UPIN
AZZ162077Medicare PIN
AZZ163167Medicare PIN
AZZ163165Medicare PIN
AZZ162075Medicare PIN
AZ105709Medicare ID - Type UnspecifiedMEDICARE
AZZ162078Medicare PIN
AZZ162076Medicare PIN
AZZ163166Medicare PIN
AZZ163163Medicare PIN
AZZ163164Medicare PIN
AZZ162074Medicare PIN
AZZ162079Medicare PIN
AZZ163162Medicare PIN