Provider Demographics
NPI:1225185929
Name:HA, THOMAS THUAN (OD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:THUAN
Last Name:HA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:10660 SOUTHERN HIGHLANDS PARKWAY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89141
Mailing Address - Country:US
Mailing Address - Phone:702-435-6527
Mailing Address - Fax:702-263-9637
Practice Address - Street 1:10660 SOUTHERN HIGHLANDS PARKWAY
Practice Address - Street 2:SUITE 101
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89141
Practice Address - Country:US
Practice Address - Phone:702-435-6527
Practice Address - Fax:702-263-9637
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV459152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100509728Medicaid
NV1316164437OtherGROUP NPI
NVV37587Medicare PIN
NVU95350Medicare UPIN