Provider Demographics
NPI:1417140195
Name:ZANJANCHIAN, SARETTA (OD)
Entity Type:Individual
Prefix:DR
First Name:SARETTA
Middle Name:
Last Name:ZANJANCHIAN
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 1:5934 W PARKER RD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-6409
Mailing Address - Country:US
Mailing Address - Phone:972-312-0177
Mailing Address - Fax:972-312-0134
Practice Address - Street 1:5934 W PARKER RD
Practice Address - Street 2:SUITE 500
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-6409
Practice Address - Country:US
Practice Address - Phone:972-312-0177
Practice Address - Fax:972-312-0134
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-24
Last Update Date:2007-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7080T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist