Provider Demographics
NPI:1649590431
Name:SUKENIK, OLGA TABAKMAN (OD)
Entity Type:Individual
Prefix:DR
First Name:OLGA
Middle Name:TABAKMAN
Last Name:SUKENIK
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3405 MIDWAY RD STE 421
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8144
Mailing Address - Country:US
Mailing Address - Phone:972-801-2727
Mailing Address - Fax:972-943-3485
Practice Address - Street 1:3405 MIDWAY RD STE 421
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8144
Practice Address - Country:US
Practice Address - Phone:972-801-2727
Practice Address - Fax:972-943-3485
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-03
Last Update Date:2014-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7841T152W00000X
TX7841TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist