Provider Demographics
NPI:1306092317
Name:KHA, THU HOA THI (OD)
Entity type:Individual
Prefix:
First Name:THU HOA
Middle Name:THI
Last Name:KHA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:THU
Other - Middle Name:
Other - Last Name:KHA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:15129 SHELLWOOD LN
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-6493
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2401 S STEMMONS FWY
Practice Address - Street 2:SUITE 2214
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-8775
Practice Address - Country:US
Practice Address - Phone:972-459-4908
Practice Address - Fax:972-315-5126
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-10
Last Update Date:2008-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7259T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist