Provider Demographics
NPI:1225582372
Name:RAFI, SOHA S (OD)
Entity Type:Individual
Prefix:
First Name:SOHA
Middle Name:S
Last Name:RAFI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:SOHA
Other - Middle Name:S
Other - Last Name:ZAHIR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6533 PRESTON RD STE 100
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-2689
Mailing Address - Country:US
Mailing Address - Phone:469-606-9686
Mailing Address - Fax:
Practice Address - Street 1:6533 PRESTON RD STE 100
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-2689
Practice Address - Country:US
Practice Address - Phone:469-606-9686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-06
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901005006152W00000X
TX9922152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty