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NPI Code Detail

MEDICARE: DR. IRA HERMAN O.D.

MEDICARE: DR. IRA HERMAN 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
1152W00000XOptometristOA04004NJ

General Provider Information

NPI Number : 1174567234
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. IRA HERMAN O.D.
Provider Business Mailing Address
First Line : 2801 E INTERSTATE 20
Second Line :
City : HUDSON OAKS
State : TX
Zip : 76087-8596
Country : US
Telephone Number : 213-737-5207
Fax Number : 682-738-2043
Provider Business Practice Location Address
First Line : 2801 E INTERSTATE 20
Second Line :
City : HUDSON OAKS
State : TX
Zip : 76087-8596
Country : US
Telephone Number : 213-737-5207
Fax Number : 682-738-2043
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2006
Last Update Date : 12/05/2025

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