Provider Demographics
NPI:1780721985
Name:DO, THUY TRACY (OD)
Entity type:Individual
Prefix:DR
First Name:THUY
Middle Name:TRACY
Last Name:DO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5906 SIERRA GRANDE DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-5146
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9616 N LAMAR BLVD
Practice Address - Street 2:STE. 159
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78753-4152
Practice Address - Country:US
Practice Address - Phone:512-835-9226
Practice Address - Fax:512-835-7413
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4187T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00777PMedicare ID - Type Unspecified
TXU95858Medicare UPIN