Provider Demographics
NPI:1306295951
Name:DOAN, THANG
Entity type:Individual
Prefix:DR
First Name:THANG
Middle Name:
Last Name:DOAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 WIGWAM PKWY APT 5102
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-8251
Mailing Address - Country:US
Mailing Address - Phone:773-987-2822
Mailing Address - Fax:
Practice Address - Street 1:1000 N GREEN VALLEY PKWY STE 420
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-6172
Practice Address - Country:US
Practice Address - Phone:725-502-2802
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-05
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046010982152W00000X
NV979152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist