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General NPI Number Information
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NPI Number | 1972088060
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Entity Type | Organization
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Legal Business Name | LONE STAR EYE SPECIALISTS
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Dates
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Enumeration Date | 09/25/2018
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Last Update Date | 12/02/2019
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Provider Practice Location Address
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Address Line | 11500 STATE HWY 121 UNIT #720
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City | FRISCO
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State | TX
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Zip | 75035
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Country | US
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Telephone | 972-362-5577
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Fax |
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Provider Business Mailing Address
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Address Line | 11500 STATE HWY 121 UNIT #720
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City | FRISCO
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State | TX
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Zip | 75035
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Country | US
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Telephone | 732-890-7885
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Fax |
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Authorized Official
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Title or Position | MEDICAL DOCTOR/ OWNER
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Name | DR. MAHDI ROSTAMIZADEH
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Credential |
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Telephone | 732-890-7885
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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