Provider Demographics
NPI:1104952217
Name:HUEY AND HSIAO OPTOMETRIC CORPORATION
Entity type:Organization
Organization Name:HUEY AND HSIAO OPTOMETRIC CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:HUEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:916-422-1066
Mailing Address - Street 1:9174 FRANKLIN BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-5524
Mailing Address - Country:US
Mailing Address - Phone:916-422-1066
Mailing Address - Fax:916-422-1162
Practice Address - Street 1:9174 FRANKLIN BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-5524
Practice Address - Country:US
Practice Address - Phone:916-422-1066
Practice Address - Fax:916-422-1162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-25
Last Update Date:2015-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ29704ZMedicare PIN