Provider Demographics
NPI:1285989228
Name:TEXAS EYE SURGEONS PA
Entity type:Organization
Organization Name:TEXAS EYE SURGEONS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ABDULFATAH
Authorized Official - Middle Name:M
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:469-999-8850
Mailing Address - Street 1:825 LOTUS DR
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-5197
Mailing Address - Country:US
Mailing Address - Phone:469-999-8850
Mailing Address - Fax:866-482-0873
Practice Address - Street 1:825 LOTUS DR
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-5197
Practice Address - Country:US
Practice Address - Phone:469-999-8850
Practice Address - Fax:866-482-0873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPO532174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
X0183272OtherCONTROLLED SUBSTANCE
TXPO532OtherSTATE LICENSE
1053382937OtherINDIVIDUAL NPI
1053382937OtherINDIVIDUAL NPI
TXPO532OtherSTATE LICENSE