Provider Demographics
NPI:1326326232
Name:DAVOODI, MAHDOKHT (OD, MS)
Entity Type:Individual
Prefix:DR
First Name:MAHDOKHT
Middle Name:
Last Name:DAVOODI
Suffix:
Gender:F
Credentials:OD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25640 KUYKENDAHL RD STE G
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-1872
Mailing Address - Country:US
Mailing Address - Phone:346-808-7342
Mailing Address - Fax:
Practice Address - Street 1:25640 KUYKENDAHL RD STE G
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-1872
Practice Address - Country:US
Practice Address - Phone:346-808-7342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-26
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9579TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist