Provider Demographics
NPI:1710408521
Name:NGO, THAO NGOC (OD)
Entity Type:Individual
Prefix:DR
First Name:THAO
Middle Name:NGOC
Last Name:NGO
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 1:5133 YAUPON DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76018-1681
Mailing Address - Country:US
Mailing Address - Phone:682-521-7919
Mailing Address - Fax:
Practice Address - Street 1:2108 DALLAS PKWY STE 206
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-4362
Practice Address - Country:US
Practice Address - Phone:866-755-2026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-30
Last Update Date:2017-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9155T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist