Provider Demographics
NPI:1619522281
Name:BABAEI, ANSEH (OD)
Entity Type:Individual
Prefix:DR
First Name:ANSEH
Middle Name:
Last Name:BABAEI
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 1:8880 STATE HIGHWAY 121 STE 141
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-3107
Mailing Address - Country:US
Mailing Address - Phone:698-546-7874
Mailing Address - Fax:
Practice Address - Street 1:8880 STATE HIGHWAY 121 STE 141
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-3107
Practice Address - Country:US
Practice Address - Phone:469-854-6787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-09
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9822152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist