Provider Demographics
NPI:1457646937
Name:TA, KATHY HOANG (MD)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:HOANG
Last Name:TA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:4315 HOUMA BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2940
Mailing Address - Country:US
Mailing Address - Phone:504-456-9061
Mailing Address - Fax:504-888-6045
Practice Address - Street 1:4315 HOUMA BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2940
Practice Address - Country:US
Practice Address - Phone:504-456-9061
Practice Address - Fax:504-888-6045
Is Sole Proprietor?:No
Enumeration Date:2011-06-13
Last Update Date:2020-01-15
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Provider Licenses
StateLicense IDTaxonomies
LAMD.207706207W00000X, 207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2148893Medicaid
LA503526ZU6FMedicare PIN
LA503526ZU5WMedicare PIN