Provider Demographics
NPI:1104279835
Name:KHOJA, FARRAH (OD)
Entity type:Individual
Prefix:MS
First Name:FARRAH
Middle Name:
Last Name:KHOJA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2906 S BAGDAD RD
Mailing Address - Street 2:STE 250
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641-3274
Mailing Address - Country:US
Mailing Address - Phone:512-243-6434
Mailing Address - Fax:
Practice Address - Street 1:2906 S BAGDAD RD
Practice Address - Street 2:STE 250
Practice Address - City:LEANDER
Practice Address - State:TX
Practice Address - Zip Code:78641-3274
Practice Address - Country:US
Practice Address - Phone:512-243-6434
Practice Address - Fax:512-910-2555
Is Sole Proprietor?:No
Enumeration Date:2016-07-18
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8974T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist