Provider Demographics
NPI:1942743794
Name:DANG, TUONG (OD)
Entity type:Individual
Prefix:
First Name:TUONG
Middle Name:
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 1:15900 LA CANTERA PKWY
Mailing Address - Street 2:6697
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78256-2587
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15900 LA CANTERA PKWY
Practice Address - Street 2:SUITE 6697
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78256-2587
Practice Address - Country:US
Practice Address - Phone:210-694-4110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-28
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9089152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist