Healthcare Provider Details

I. General information

NPI: 1992866909
Provider Name (Legal Business Name): SAIRAH IHSAN MALIK O.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 SOUTHWEST FWY STE 112
HOUSTON TX
77027-7586
US

IV. Provider business mailing address

3800 SOUTHWEST FWY STE 112
HOUSTON TX
77027-7586
US

V. Phone/Fax

Practice location:
  • Phone: 956-661-9000
  • Fax: 956-686-7833
Mailing address:
  • Phone: 713-360-7095
  • Fax: 832-460-1303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number6717TG
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: