Individual
DR. KELLY PHUONG PHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
18700 LIMESTONE COMMERCIAL DR, PFLUGERVILLE, TX 78660-6544
(512) 990-1440
(512) 990-3691
Mailing address
3810 CONCORD DR, ROUND ROCK, TX 78665-1314
(405) 761-2872
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
7380T
TX
Other
Enumeration date
07/06/2009
Last updated
07/06/2009
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