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General NPI Number Information
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NPI Number | 1053392696
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Entity Type | Individual
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Provider Name | MARK SHERSTINSKY O.D.
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Gender | Male
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Dates
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Enumeration Date | 11/10/2005
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 915 GESSNER RD STE 100
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City | HOUSTON
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State | TX
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Zip | 77024-2537
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Country | US
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Telephone | 713-242-2222
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Fax |
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Provider Business Mailing Address
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Address Line | 3916 S BROADWAY
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City | LOS ANGELES
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State | CA
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Zip | 90037-1307
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Country | US
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Telephone | 323-234-9137
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Fax | 323-235-6203
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | VUT006400
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 11397
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 12180TLG
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License Number State | CA
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