Provider Demographics
NPI:1639189681
Name:AMIR, FARSHID (OD)
Entity Type:Individual
Prefix:
First Name:FARSHID
Middle Name:
Last Name:AMIR
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9577 HUEBNER RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-1687
Mailing Address - Country:US
Mailing Address - Phone:210-523-6616
Mailing Address - Fax:210-641-4998
Practice Address - Street 1:9577 HUEBNER RD
Practice Address - Street 2:SUITE 3
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1687
Practice Address - Country:US
Practice Address - Phone:210-523-6616
Practice Address - Fax:210-641-4998
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2014-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4766TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
742968437OtherBCBS
TX156083101Medicaid
TXU43885Medicare UPIN
TX00E44TMedicare PIN