Provider Demographics
NPI:1588611172
Name:GARZA, BITA YOUSEFI (OD)
Entity type:Individual
Prefix:DR
First Name:BITA
Middle Name:YOUSEFI
Last Name:GARZA
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 1:7638 STONEBROOK PKWY
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-1003
Mailing Address - Country:US
Mailing Address - Phone:972-712-1010
Mailing Address - Fax:972-712-1011
Practice Address - Street 1:7638 STONEBROOK PKWY
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-1003
Practice Address - Country:US
Practice Address - Phone:972-712-1010
Practice Address - Fax:972-712-1011
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2010-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6439TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1588611172OtherNPI
TX1234530001OtherGROUP DMERC
TX00E41YOtherGROUP PIN
TX1902852346OtherGROUP NPI
TX752711435OtherGROUP TAX ID
TXDO9312Medicare PIN
TX752711435OtherGROUP TAX ID
TX1588611172OtherNPI