MEDICARE: ZAHEER HABIBI OPTICIAN

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	156FX1800X	Optician

General Provider Information

NPI Number	:	1447636600
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZAHEER HABIBI OPTICIAN

Provider Business Mailing Address
First Line	:	2536 MALL CIR
Second Line	:	SUITE D
City	:	FORT WORTH
State	:	TX
Zip	:	76116-1545
Country	:	US
Telephone Number	:	817-731-7434
Fax Number	:	817-738-2043

Provider Business Practice Location Address
First Line	:	2536 MALL CIR
Second Line	:	SUITE D
City	:	FORT WORTH
State	:	TX
Zip	:	76116-1545
Country	:	US
Telephone Number	:	817-731-7434
Fax Number	:	817-738-2043

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

Provider Enumeration Date	:	08/10/2015
Last Update Date	:	01/14/2016

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