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NPI Code Detail

MEDICARE: ALIREZA SOMJI O.D.

MEDICARE: ALIREZA SOMJI O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist7805TTX
2152WC0802XCorneal and Contact Management Optometrist7805TTX

General Provider Information

NPI Number : 1801183900
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALIREZA SOMJI O.D.
Provider Business Mailing Address
First Line : 15920 LEXINGTON BLVD
Second Line :
City : SUGAR LAND
State : TX
Zip : 77479-2313
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 15920 LEXINGTON BLVD
Second Line :
City : SUGAR LAND
State : TX
Zip : 77479-2313
Country : US
Telephone Number : 281-265-3937
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2011
Last Update Date : 09/25/2012

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