Provider Demographics
NPI:1114815883
Name:VANG, LINDA LY (OD)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:LY
Last Name:VANG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 9TH ST NW
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:IA
Mailing Address - Zip Code:50009-4210
Mailing Address - Country:US
Mailing Address - Phone:651-208-4313
Mailing Address - Fax:
Practice Address - Street 1:301 CENTER PL SW STE D
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:IA
Practice Address - Zip Code:50009-2589
Practice Address - Country:US
Practice Address - Phone:515-967-4095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-24
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA131740152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist