Provider Demographics
NPI:1376879551
Name:HASHEMI & ASSOCIATE O.D.,P.A
Entity Type:Organization
Organization Name:HASHEMI & ASSOCIATE O.D.,P.A
Other - Org Name:EYE EXAM PROS, DALLAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HAMID
Authorized Official - Middle Name:
Authorized Official - Last Name:HASHEMI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:972-862-6699
Mailing Address - Street 1:PO BOX 260596
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75026-0596
Mailing Address - Country:US
Mailing Address - Phone:972-862-6699
Mailing Address - Fax:972-862-6611
Practice Address - Street 1:18121 MARSH LN STE 6
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75287-5742
Practice Address - Country:US
Practice Address - Phone:972-862-6699
Practice Address - Fax:972-862-6611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-23
Last Update Date:2009-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6174TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX166457501Medicaid
TXU91834Medicare UPIN