Provider Demographics
NPI:1316015902
Name:IYER, BHAVANI R (OD, FAAO)
Entity type:Individual
Prefix:DR
First Name:BHAVANI
Middle Name:R
Last Name:IYER
Suffix:
Gender:F
Credentials:OD, FAAO
Other - Prefix:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 FANNIN ST STE 1800
Mailing Address - Street 2:UNIVERSITY EYE ASSOCIATES /ROBERT CIZIK EYE CLINIC
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1526
Mailing Address - Country:US
Mailing Address - Phone:713-559-5200
Mailing Address - Fax:713-559-5292
Practice Address - Street 1:6400 FANNIN ST STE 1800
Practice Address - Street 2:UNIVERSITY EYE ASSOCIATES /ROBERT CIZIK EYE CLINIC
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1526
Practice Address - Country:US
Practice Address - Phone:713-559-5200
Practice Address - Fax:713-559-5292
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7149T152W00000X
TX07149T152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
No152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1913444-03Medicaid
BI003892OtherCHAMPUS-CHAMPUS
BI003892OtherCOMMERCIAL-COMMERCIAL NUMBER
TX1913444-01Medicaid
TX8K2019Medicare PIN