Thu Van Od PA

Optometrist in Conway, AR. Organization (NPI-2).

NPI number1154740686

StatusActive

Last updated in NPPESAug 26, 2026

Details

NPI: 1154740686
Entity type: Organization (NPI-2)
Legal business name: Thu Van Od PA
Organization subpart: No
Enumeration date: Apr 11, 2014
Certification date: Aug 26, 2026
Last updated: Aug 26, 2026

Medicare and OIG

Medicare enrolled (PECOS): Yes · PART B SUPPLIER - CLINIC/GROUP PRACTICE
Can order and refer: Not on the CMS order and referring list
OIG exclusion list: This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
152W00000X	Optometrist	2587	AR	Yes

Practice location

1155 Skyline Dr
Conway, AR 72032-2857

Phone 501-329-2020 · Fax 501-329-2021

Mailing address

7420 Palm Beach Ave
Benton, AR 72019-2023

Other practice locations

1910 Martin Luther King Blvd
Malvern, AR 72104-2203

Phone 501-332-7558 · Fax 501-332-7221

Authorized official

Justin Dang
Manager
5013292020

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Optometrist providers in Conway, AR

All 33 Optometrist providers in Conway · All 3,490 providers in Conway

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