Provider Demographics
NPI:1942355615
Name:VO, RYAN NHAN (OD)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:NHAN
Last Name:VO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1202 ELGIN ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-2829
Mailing Address - Country:US
Mailing Address - Phone:713-739-9008
Mailing Address - Fax:713-739-8318
Practice Address - Street 1:1202 ELGIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-2829
Practice Address - Country:US
Practice Address - Phone:713-739-9008
Practice Address - Fax:713-739-8318
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5284TG152W00000X, 152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered152W00000XEye and Vision Services ProvidersOptometrist
Not Answered152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU62256Medicare UPIN
TXOOE29VMedicare ID - Type Unspecified