Provider Demographics
NPI:1386796308
Name:LINTAKOON, POUN T (OD)
Entity type:Individual
Prefix:
First Name:POUN
Middle Name:T
Last Name:LINTAKOON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:POUN
Other - Middle Name:TU-MIEN
Other - Last Name:LINTAKOON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:9188 BELLAIRE BLVD
Mailing Address - Street 2:SUITE I
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-4623
Mailing Address - Country:US
Mailing Address - Phone:713-271-9188
Mailing Address - Fax:
Practice Address - Street 1:9188 BELLAIRE BLVD
Practice Address - Street 2:SUITE I
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-4623
Practice Address - Country:US
Practice Address - Phone:713-271-9188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX03359152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
000023FAMedicare ID - Type Unspecified
4697322609Medicare UPIN