Provider Demographics
NPI:1295174308
Name:LO, AMY HAI YAN (OD)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:HAI YAN
Last Name:LO
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 1:20055 TELEGRAPH SQUARE LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-3237
Mailing Address - Country:US
Mailing Address - Phone:281-398-9007
Mailing Address - Fax:
Practice Address - Street 1:6502 GARTH RD STE 200A
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-9889
Practice Address - Country:US
Practice Address - Phone:281-421-9493
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-21
Last Update Date:2013-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7749152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist