Provider Demographics
NPI:1235253063
Name:BAINS, AMRITA (OD)
Entity Type:Individual
Prefix:DR
First Name:AMRITA
Middle Name:
Last Name:BAINS
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 1:26323 MORNING CYPRESS LN
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-2857
Mailing Address - Country:US
Mailing Address - Phone:281-256-8774
Mailing Address - Fax:281-256-8543
Practice Address - Street 1:25905 US HWY 290
Practice Address - Street 2:SUITE A
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433
Practice Address - Country:US
Practice Address - Phone:281-256-8774
Practice Address - Fax:281-256-8543
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6036T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXV05461Medicare UPIN