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General NPI Number Information
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NPI Number | 1912018425
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Entity Type | Individual
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Provider Name | MUMTAZ PYARALI TEJANI O.D.
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Gender | Female
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 494 W INTERSTATE 30
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City | ROYSE CITY
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State | TX
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Zip | 75189-7527
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Country | US
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Telephone | 972-635-2520
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Fax |
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Provider Business Mailing Address
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Address Line | 831 CEDARBLUFF DR
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City | ROCKWALL
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State | TX
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Zip | 75087-6545
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Country | US
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Telephone | 972-896-9788
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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 | 6622TG
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License Number State | TX
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