Individual
DR. LOAN THI KIM LAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
9191 KYSER WAY, SUITE # 600, FRISCO, TX 75033-1953
(214) 705-9433
Mailing address
9191 KYSER WAY STE 602, FRISCO, TX 75033-1903
(214) 705-9433
(214) 705-9318
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
7605TG
TX
152WP0200X
Pediatric Optometrist
7605TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
219714701
—
TX
01
—
TXB115266
MEDICARE PTAN
—
Enumeration date
07/13/2010
Last updated
06/19/2024
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