Provider Demographics
NPI:1417568635
Name:WAQAR, YASEEN (OD)
Entity type:Individual
Prefix:DR
First Name:YASEEN
Middle Name:
Last Name:WAQAR
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5401 FM 1626 STE 110
Mailing Address - Street 2:
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640-6039
Mailing Address - Country:US
Mailing Address - Phone:254-717-9873
Mailing Address - Fax:
Practice Address - Street 1:5401 FM 1626 STE 110
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-6039
Practice Address - Country:US
Practice Address - Phone:512-268-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-11
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10001152W00000X
FLOPC5847152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist