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NPI Code Detail

MEDICARE: DR. ALI MOSTAGHIMI O.D.

MEDICARE: DR. ALI MOSTAGHIMI 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
1152W00000XOptometrist7092TTX

General Provider Information

NPI Number : 1922207323
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALI MOSTAGHIMI O.D.
Provider Business Mailing Address
First Line : PO BOX 79351
Second Line :
City : HOUSTON
State : TX
Zip : 77279-9351
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11159 WESTHEIMER RD
Second Line :
City : HOUSTON
State : TX
Zip : 77042-3218
Country : US
Telephone Number : 713-978-7504
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2007
Last Update Date : 07/16/2007

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