Provider Demographics
NPI:1578770525
Name:MY-HANH TRIEU OD, INC.
Entity Type:Organization
Organization Name:MY-HANH TRIEU OD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MY-HANH
Authorized Official - Middle Name:
Authorized Official - Last Name:TRIEU
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:703-534-8801
Mailing Address - Street 1:6015A WILSON BLVD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22205-1503
Mailing Address - Country:US
Mailing Address - Phone:703-534-8801
Mailing Address - Fax:703-534-8803
Practice Address - Street 1:6015A WILSON BLVD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-1503
Practice Address - Country:US
Practice Address - Phone:703-534-8801
Practice Address - Fax:703-534-8803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No152WX0102XEye and Vision Services ProvidersOptometristOccupational VisionGroup - Multi-Specialty
No332H00000XSuppliersEyewear SupplierGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA10051304Medicaid
VA1202001OtherALLIED EYECARE
VAJ254OtherBCBS PPO
VA487248OtherNVA
VATE23963OtherSPECTERA
VAVA02285OtherVISION BENEFIT OF AMERICA
VAVA2285OtherEYEMED
VA137406OtherANTHEM PPO, HMO
VA44447OtherDAVIS VISION
VA31691OtherAVESIS
VA469475OtherMAMSI,MDIPA,UNITED HC,
VA=========OtherPHCS PPO
VA487248OtherNVA
VA=========OtherSUPERIOR VISION SERVICES
VAJ254OtherBCBS PPO
VAVA02285OtherVISION BENEFIT OF AMERICA
VA=========OtherAETNA US HEALTHCARE
VAG01474Medicare ID - Type UnspecifiedMEDICARE #
VAVA2285OtherEYEMED