Provider Demographics
NPI:1861517484
Name:ENCISO, LINDA THUY (OD)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:THUY
Last Name:ENCISO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:2470 GRAY FALLS DR STE 150
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-6525
Mailing Address - Country:US
Mailing Address - Phone:281-556-5353
Mailing Address - Fax:281-556-5349
Practice Address - Street 1:15080 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-4302
Practice Address - Country:US
Practice Address - Phone:281-531-0300
Practice Address - Fax:281-531-0349
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6908TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8L21843Medicare PIN
TXTXB128899Medicare PIN