Provider Demographics
NPI:1174569750
Name:VIRANI, SHIROZ (OD)
Entity type:Individual
Prefix:DR
First Name:SHIROZ
Middle Name:
Last Name:VIRANI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:SHIROZ
Other - Middle Name:
Other - Last Name:KESHWANI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:1950 OLD GALLOWS RD STE 520
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3970
Mailing Address - Country:US
Mailing Address - Phone:703-847-8899
Mailing Address - Fax:571-223-6780
Practice Address - Street 1:23702 WESTHEIMER PKWY
Practice Address - Street 2:SUITE C
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-3605
Practice Address - Country:US
Practice Address - Phone:281-391-2020
Practice Address - Fax:281-391-0746
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX04038TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX04038TGOtherOPTOMETRY LICENSE
TX81489QOtherBCBS OF TEXAS
TX112423204Medicaid
TX8F2061Medicare PIN
TX04038TGOtherOPTOMETRY LICENSE
TXT86251Medicare UPIN