Provider Demographics
NPI: | 1568086015 |
---|---|
Name: | HT CLARITY PLLC |
Entity type: | Organization |
Organization Name: | HT CLARITY PLLC |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | OPTOMETRIST |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | HUY |
Authorized Official - Middle Name: | HUU |
Authorized Official - Last Name: | TRAN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | OD |
Authorized Official - Phone: | 682-554-7086 |
Mailing Address - Street 1: | 618 WHITE SWAN DR |
Mailing Address - Street 2: | |
Mailing Address - City: | ARLINGTON |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 76002-3341 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 682-554-7086 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 2225 W INTERSTATE 20 |
Practice Address - Street 2: | |
Practice Address - City: | GRAND PRAIRIE |
Practice Address - State: | TX |
Practice Address - Zip Code: | 75052-3926 |
Practice Address - Country: | US |
Practice Address - Phone: | 972-602-3937 |
Practice Address - Fax: | 972-456-9959 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2020-06-01 |
Last Update Date: | 2022-02-04 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 152W00000X | Eye and Vision Services Providers | Optometrist | Group - Single Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
TX | 4195000 | Medicaid |