Provider Demographics
NPI:1093531337
Name:MOIZ-HUSSAIN, HAMEED
Entity type:Individual
Prefix:
First Name:HAMEED
Middle Name:
Last Name:MOIZ-HUSSAIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:WYLIE
Mailing Address - State:TX
Mailing Address - Zip Code:75098-5577
Mailing Address - Country:US
Mailing Address - Phone:210-422-0477
Mailing Address - Fax:
Practice Address - Street 1:601 S PLANO RD
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-4512
Practice Address - Country:US
Practice Address - Phone:972-231-7642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-03
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11319152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist