Provider Demographics
NPI:1598250607
Name:MOZDBAR, SIMA TAJ (OD)
Entity type:Individual
Prefix:DR
First Name:SIMA
Middle Name:TAJ
Last Name:MOZDBAR
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:900 RANCH ROAD 620 S STE B112
Mailing Address - Street 2:
Mailing Address - City:LAKEWAY
Mailing Address - State:TX
Mailing Address - Zip Code:78734-5623
Mailing Address - Country:US
Mailing Address - Phone:512-263-0225
Mailing Address - Fax:
Practice Address - Street 1:900 RANCH ROAD 620 S STE B112
Practice Address - Street 2:
Practice Address - City:LAKEWAY
Practice Address - State:TX
Practice Address - Zip Code:78734-5623
Practice Address - Country:US
Practice Address - Phone:512-263-0225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-30
Last Update Date:2025-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9446TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist