Provider Demographics
NPI:1023485323
Name:HUYNH, HIEU KIM (OD)
Entity type:Individual
Prefix:DR
First Name:HIEU
Middle Name:KIM
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 1:1410 N PLANO RD STE 100
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-2427
Mailing Address - Country:US
Mailing Address - Phone:972-669-4141
Mailing Address - Fax:972-761-0388
Practice Address - Street 1:1410 N PLANO RD STE 100
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-2427
Practice Address - Country:US
Practice Address - Phone:972-669-4141
Practice Address - Fax:972-761-0388
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-21
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8795T152W00000X
TX8795TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty