Provider Demographics
NPI:1760863690
Name:MAHMOODPOUR, SAHAR (OD)
Entity Type:Individual
Prefix:
First Name:SAHAR
Middle Name:
Last Name:MAHMOODPOUR
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 1:5215 SCHULER ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-3215
Mailing Address - Country:US
Mailing Address - Phone:832-512-1655
Mailing Address - Fax:
Practice Address - Street 1:8717 HIGHWAY 6 N
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-2204
Practice Address - Country:US
Practice Address - Phone:832-512-1655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-16
Last Update Date:2015-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8735TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist