Provider Demographics
NPI:1528120672
Name:HAZRA, BARUN KUMAR (OD)
Entity type:Individual
Prefix:DR
First Name:BARUN
Middle Name:KUMAR
Last Name:HAZRA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:6654 SOUTHWEST FWY # A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-2210
Mailing Address - Country:US
Mailing Address - Phone:281-450-0154
Mailing Address - Fax:888-872-3420
Practice Address - Street 1:11210 W AIRPORT BLVD
Practice Address - Street 2:SUITE # A
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-3000
Practice Address - Country:US
Practice Address - Phone:281-575-0757
Practice Address - Fax:281-575-9115
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX4480T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist