Provider Demographics
NPI:1700829710
Name:HATTON, LINDA FAIN (OD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:FAIN
Last Name:HATTON
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 1:5330 E MOCKINGBIRD LN
Mailing Address - Street 2:SUITE# 130
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-0940
Mailing Address - Country:US
Mailing Address - Phone:214-341-9955
Mailing Address - Fax:214-348-4545
Practice Address - Street 1:5330 E MOCKINGBIRD LN
Practice Address - Street 2:SUITE # 130
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75206-0940
Practice Address - Country:US
Practice Address - Phone:214-341-9955
Practice Address - Fax:214-348-4545
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4077TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX80734QOtherBCBS
TXT90831Medicare UPIN
TX8A0005Medicare ID - Type Unspecified