Provider Demographics
NPI:1649584087
Name:DINH, THOM (OD)
Entity Type:Individual
Prefix:
First Name:THOM
Middle Name:
Last Name:DINH
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 1:8945 CORTANA PL
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70815-8702
Mailing Address - Country:US
Mailing Address - Phone:225-929-7995
Mailing Address - Fax:225-929-7998
Practice Address - Street 1:8945 CORTANA PL
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70815-8702
Practice Address - Country:US
Practice Address - Phone:225-766-9907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-27
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1598-631T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist