Provider Demographics
NPI:1346792918
Name:HAIDER, GREYSSY LIZETH (OD)
Entity Type:Individual
Prefix:DR
First Name:GREYSSY
Middle Name:LIZETH
Last Name:HAIDER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:MRS
Other - First Name:GREYSSY
Other - Middle Name:LIZETH
Other - Last Name:HAIDER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2049 TOURNAMENT DR
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-7933
Mailing Address - Country:US
Mailing Address - Phone:818-274-2817
Mailing Address - Fax:
Practice Address - Street 1:7002 SHALLOWFORD RD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-1715
Practice Address - Country:US
Practice Address - Phone:423-499-0810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-31
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2551152W00000X
TN3763152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist