MEDICARE: ATIYA E HUSAIN O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	6591TG	TX

General Provider Information

NPI Number	:	1053401091
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ATIYA E HUSAIN O.D.

Provider Business Mailing Address
First Line	:	10031 BRIAR FOREST DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77042-2415
Country	:	US
Telephone Number	:	713-952-9098
Fax Number	:

Provider Business Practice Location Address
First Line	:	16200 CITY WALK
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-6543
Country	:	US
Telephone Number	:	281-265-2000
Fax Number	:	281-265-2141

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/13/2006
Last Update Date	:	12/03/2010

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