Provider Demographics
NPI:1649562794
Name:FAZ EYECARE
Entity Type:Organization
Organization Name:FAZ EYECARE
Other - Org Name:TEXAS STATE OPTICAL - SPRING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:THERAPEUTIC OPTOMETRIST/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALNAZ
Authorized Official - Middle Name:
Authorized Official - Last Name:FAZLALIZADEH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:832-594-7156
Mailing Address - Street 1:19752 NORTH FWY STE B
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77373-5301
Mailing Address - Country:US
Mailing Address - Phone:832-594-7156
Mailing Address - Fax:
Practice Address - Street 1:19752 NORTH FWY STE B
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77373-5301
Practice Address - Country:US
Practice Address - Phone:832-594-7156
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-09
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7443TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty