Provider Demographics
NPI:1649416686
Name:HOANG YEN OD
Entity Type:Organization
Organization Name:HOANG YEN OD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF OPTOMETRY
Authorized Official - Prefix:
Authorized Official - First Name:YEN
Authorized Official - Middle Name:H
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:281-758-3083
Mailing Address - Street 1:24120 NORTHWEST FREEWAY
Mailing Address - Street 2:SUITE 600
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429
Mailing Address - Country:US
Mailing Address - Phone:281-758-3083
Mailing Address - Fax:281-758-3084
Practice Address - Street 1:24120 NORTHWEST FREEWAY
Practice Address - Street 2:SUITE 600
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429
Practice Address - Country:US
Practice Address - Phone:281-758-3083
Practice Address - Fax:281-758-3084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-22
Last Update Date:2009-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4887T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4887TOtherTEXAS OPTOMETRY LICENSE