Healthcare Provider Details

I. General information

NPI: 1275451411
Provider Name (Legal Business Name): KATIE RIZK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 SINGING HILLS BLVD
SIOUX CITY IA
51106-9702
US

IV. Provider business mailing address

642 BLUESTEM TRL
DAKOTA DUNES SD
57049-5451
US

V. Phone/Fax

Practice location:
  • Phone: 712-271-4600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number139524
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: