Provider Demographics
NPI:1114597234
Name:WASTANI, ARZOO (OD)
Entity type:Individual
Prefix:DR
First Name:ARZOO
Middle Name:
Last Name:WASTANI
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 1:1825 SAN JACINTO ST UNIT 413
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-8253
Mailing Address - Country:US
Mailing Address - Phone:214-436-9090
Mailing Address - Fax:
Practice Address - Street 1:19210 GULF FWY
Practice Address - Street 2:
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-2705
Practice Address - Country:US
Practice Address - Phone:832-224-4766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-30
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10295T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist