Provider Demographics
NPI:1124516927
Name:HOANG SQUARED
Entity type:Organization
Organization Name:HOANG SQUARED
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER, OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MINA
Authorized Official - Middle Name:BAO
Authorized Official - Last Name:HOANG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:832-212-2701
Mailing Address - Street 1:209 PALMER ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77003-2303
Mailing Address - Country:US
Mailing Address - Phone:832-212-2701
Mailing Address - Fax:
Practice Address - Street 1:11020 HARLEM RD STE 800
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406
Practice Address - Country:US
Practice Address - Phone:832-212-2701
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-26
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7762TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty