Provider Demographics
NPI:1205216934
Name:ATTRI, SRISHTI (OD)
Entity Type:Individual
Prefix:
First Name:SRISHTI
Middle Name:
Last Name:ATTRI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3828 SHIVER RD
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-8688
Mailing Address - Country:US
Mailing Address - Phone:817-741-1073
Mailing Address - Fax:817-741-1079
Practice Address - Street 1:9549 SAGE MEADOW TRL
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76177-8595
Practice Address - Country:US
Practice Address - Phone:817-741-1073
Practice Address - Fax:817-741-1079
Is Sole Proprietor?:No
Enumeration Date:2015-06-08
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC5051152W00000X
TX9328TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX35809OtherDAVIS VISION
TX319219OtherVSP
TX8225904990145OtherNVA
TX268853OtherSPECTERA
TX84336OtherAVESIS
TX84336OtherAVESIS