MEDICARE: SUKAINA FATIMA ZAIDI OD

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	10487	TX

General Provider Information

NPI Number	:	1396471751
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUKAINA FATIMA ZAIDI OD

Provider Business Mailing Address
First Line	:	6502 GLEN CANYON CT
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77450-5412
Country	:	US
Telephone Number	:	734-674-4363
Fax Number	:

Provider Business Practice Location Address
First Line	:	26914 FM 1093 RD STE 200
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77406-3621
Country	:	US
Telephone Number	:	346-307-8306
Fax Number	:

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

Provider Enumeration Date	:	07/28/2022
Last Update Date	:	07/28/2022

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