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General NPI Number Information
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NPI Number | 1760450423
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Entity Type | Individual
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Provider Name | SUSAN SHAHRIARI O.D.
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Gender | Female
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Dates
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Enumeration Date | 03/09/2006
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Last Update Date | 03/21/2008
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Provider Practice Location Address
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Address Line | 4400 NORTH FWY # B SUITE 300
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City | HOUSTON
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State | TX
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Zip | 77022-3604
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Country | US
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Telephone | 713-697-2081
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Fax |
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Provider Business Mailing Address
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Address Line | 1829 AUGUSTA DR SUITE #8
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City | HOUSTON
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State | TX
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Zip | 77057-3143
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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 | 3846T
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License Number State | TX
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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 | 9419
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License Number State | CA
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