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General NPI Number Information
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NPI Number | 1386909703
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Entity Type | Individual
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Provider Name | HALEH EBRAHIMI
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Gender | Female
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Dates
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Enumeration Date | 07/11/2012
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Last Update Date | 05/24/2021
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Provider Practice Location Address
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Address Line | 915 GESSNER RD STE 250
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City | HOUSTON
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State | TX
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Zip | 77024-2534
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Country | US
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Telephone | 713-467-5660
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Fax |
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Provider Business Mailing Address
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Address Line | 2855 GRAMERCY ST STE 400
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City | HOUSTON
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State | TX
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Zip | 77025-1756
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Country | US
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Telephone |
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Fax |
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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 | 9945T
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License Number State | TX
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