Healthcare Provider Details

I. General information

NPI: 1881413888
Provider Name (Legal Business Name): OCULUSDOC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2024
Last Update Date: 12/02/2024
Certification Date: 12/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24441 KATY FWY STE 300
KATY TX
77494-1429
US

IV. Provider business mailing address

24441 KATY FWY STE 300
KATY TX
77494-1429
US

V. Phone/Fax

Practice location:
  • Phone: 346-837-2481
  • Fax:
Mailing address:
  • Phone: 346-837-2481
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. ALINA ISHTIAQ
Title or Position: CEO, OWNER
Credential: OD
Phone: 346-837-2481