Provider Demographics
NPI:1629415336
Name:PHILLIP DOAN, OD, PLLC
Entity Type:Organization
Organization Name:PHILLIP DOAN, OD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:
Authorized Official - Last Name:DOAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:832-491-3436
Mailing Address - Street 1:8250 PARK PLACE BLVD
Mailing Address - Street 2:402
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77017-3130
Mailing Address - Country:US
Mailing Address - Phone:832-491-3436
Mailing Address - Fax:713-643-6769
Practice Address - Street 1:10505 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-8076
Practice Address - Country:US
Practice Address - Phone:832-491-3436
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-04
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty