MEDICARE: HASHEMI & ASSOCIATES O.D., P.A.

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	6174 TG	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689851446
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HASHEMI & ASSOCIATES O.D., P.A.

Provider Business Mailing Address
First Line	:	PO BOX 260596
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75026-0596
Country	:	US
Telephone Number	:	972-370-3937
Fax Number	:	972-370-2128

Provider Business Practice Location Address
First Line	:	4691 HWY 121
Second Line	:	SUITE#700
City	:	LEWISVILLE
State	:	TX
Zip	:	75056-4010
Country	:	US
Telephone Number	:	972-370-3937
Fax Number	:	972-370-2128

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	DR. HAMID HASHEMI
Credential	:	O.D
Telephone Number	:	972-370-3937

Provider Enumeration Date	:	01/23/2008
Last Update Date	:	10/07/2009

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