Provider Demographics
NPI:1932581253
Name:BLOIS, KIM TIEN (OD)
Entity type:Individual
Prefix:DR
First Name:KIM
Middle Name:TIEN
Last Name:BLOIS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4308 KESTREL WAY
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-4683
Mailing Address - Country:US
Mailing Address - Phone:940-369-7441
Mailing Address - Fax:940-369-7403
Practice Address - Street 1:1800 W CHESTNUT ST STE 101
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201
Practice Address - Country:US
Practice Address - Phone:940-369-7441
Practice Address - Fax:940-369-7403
Is Sole Proprietor?:No
Enumeration Date:2015-06-23
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8661TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist