MEDICARE: IMRAN R BAIG OD PLLC

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	152WC0802X	Corneal and Contact Management Optometrist	5709T	TX

General Provider Information

NPI Number	:	1154768984
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IMRAN R BAIG OD PLLC

Provider Business Mailing Address
First Line	:	10415 MIDDLEROSE LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77070-3486
Country	:	US
Telephone Number	:	281-477-3427
Fax Number	:	281-477-3427

Provider Business Practice Location Address
First Line	:	12205 WEST RD
Second Line	:
City	:	JERSEY VILLAGE
State	:	TX
Zip	:	77065-4522
Country	:	US
Telephone Number	:	281-477-3427
Fax Number	:	281-477-3427

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	DR. IMRAN REHAN BAIG
Credential	:	O.D
Telephone Number	:	281-477-3427

Provider Enumeration Date	:	06/03/2013
Last Update Date	:	06/03/2013

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