Provider Demographics
NPI:1780641076
Name:RATTAN, JUDY (OD)
Entity Type:Individual
Prefix:DR
First Name:JUDY
Middle Name:
Last Name:RATTAN
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 1:2633 GALLANT FOX DR
Mailing Address - Street 2:
Mailing Address - City:SCHERTZ
Mailing Address - State:TX
Mailing Address - Zip Code:78108-2318
Mailing Address - Country:US
Mailing Address - Phone:405-479-4929
Mailing Address - Fax:
Practice Address - Street 1:221 3RD ST W
Practice Address - Street 2:359 AMDS/SGPE
Practice Address - City:JBSA RANDOLPH
Practice Address - State:TX
Practice Address - Zip Code:78150-4800
Practice Address - Country:US
Practice Address - Phone:210-652-5526
Practice Address - Fax:210-652-6348
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-28
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3499152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist