Provider Demographics
NPI:1508808809
Name:THAI, HANG (OD)
Entity Type:Individual
Prefix:DR
First Name:HANG
Middle Name:
Last Name:THAI
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 1:1403 LAKE WHITNEY DR
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-6071
Mailing Address - Country:US
Mailing Address - Phone:321-662-3629
Mailing Address - Fax:
Practice Address - Street 1:3119 DANIELS RD STE 110
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-7012
Practice Address - Country:US
Practice Address - Phone:407-654-5453
Practice Address - Fax:407-654-5423
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC4071152W00000X
FLOPC 4071152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDV00074Medicare ID - Type Unspecified
FLAA6094Medicare PIN