Provider Demographics
NPI:1801998356
Name:HUYNH, THANH T (OD)
Entity type:Individual
Prefix:DR
First Name:THANH
Middle Name:T
Last Name:HUYNH
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 1:7302 BRANFORD PARK LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-8006
Mailing Address - Country:US
Mailing Address - Phone:281-579-8300
Mailing Address - Fax:
Practice Address - Street 1:1025 HIGHWAY 6 N
Practice Address - Street 2:STE. A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-1004
Practice Address - Country:US
Practice Address - Phone:281-579-8300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6676T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1738353Medicaid
TXV03441Medicare UPIN
TX611408Medicare ID - Type Unspecified