Provider Demographics
NPI:1952452278
Name:RAHMAN, SHUSMITA H (OD FAAO)
Entity Type:Individual
Prefix:
First Name:SHUSMITA
Middle Name:H
Last Name:RAHMAN
Suffix:
Gender:F
Credentials:OD FAAO
Other - Prefix:
Other - First Name:SHUSMITA
Other - Middle Name:
Other - Last Name:RAHMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSTOM
Mailing Address - Street 1:9500 S IH 35 STE G
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-1753
Mailing Address - Country:US
Mailing Address - Phone:619-549-5593
Mailing Address - Fax:512-292-9108
Practice Address - Street 1:9500 S IH 35 STE G
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-1753
Practice Address - Country:US
Practice Address - Phone:619-549-5593
Practice Address - Fax:512-292-9108
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10996152W00000X
TX5326T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU94116Medicare UPIN
CAWOP10996Medicare ID - Type Unspecified