Provider Demographics
NPI:1104487271
Name:SAAKOVA, LILIT (OD)
Entity type:Individual
Prefix:
First Name:LILIT
Middle Name:
Last Name:SAAKOVA
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 1:1251 E SOUTHLAKE BLVD STE 331
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-6478
Mailing Address - Country:US
Mailing Address - Phone:817-668-6393
Mailing Address - Fax:
Practice Address - Street 1:1251 E SOUTHLAKE BLVD STE 333
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-6478
Practice Address - Country:US
Practice Address - Phone:817-310-0289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-27
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9756T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist