Individual
DR. CAROLYN K KHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
4927 LAKE RIDGE PKWY, SUITE NUMBER 160, GRAND PRAIRIE, TX 75052-3073
(972) 641-5900
(972) 641-5903
Mailing address
4927 LAKE RIDGE PKWY, SUITE NUMBER 160, GRAND PRAIRIE, TX 75052-3073
(972) 641-5900
(972) 641-5903
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
6592TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6592TG
TX OPTOMETRY BOARD
TX
01
—
90136629
DPS REGISTRATION
TX
Enumeration date
08/19/2005
Last updated
03/07/2023
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