Provider Demographics
NPI:1952700122
Name:DANG, DANA P (OD)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:P
Last Name:DANG
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 1:130 SUNDANCE PKWY STE 300
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-7935
Mailing Address - Country:US
Mailing Address - Phone:512-630-2613
Mailing Address - Fax:
Practice Address - Street 1:130 SUNDANCE PKWY STE 300
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-7935
Practice Address - Country:US
Practice Address - Phone:512-630-2613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-13
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8502TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX390927YRCEOtherMEDICARE UPIN
TX390927YRBLOtherMEDICARE UPIN
TX349654901Medicaid