MEDICARE: ASHCON ALIZADEH 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	SOL15050	CA

General Provider Information

NPI Number	:	1538913918
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHCON ALIZADEH OD

Provider Business Mailing Address
First Line	:	3331 DAMICO ST UNIT 504
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77019-1974
Country	:	US
Telephone Number	:	832-643-7755
Fax Number	:

Provider Business Practice Location Address
First Line	:	3331 DAMICO ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77019-1943
Country	:	US
Telephone Number	:	832-643-7755
Fax Number	:

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

Provider Enumeration Date	:	04/12/2024
Last Update Date	:	03/10/2026

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Directions to “ ASHCON ALIZADEH OD” Practice Location

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