Provider Demographics
NPI:1952462566
Name:BATTANI, RODGER MARION (OD)
Entity Type:Individual
Prefix:MR
First Name:RODGER
Middle Name:MARION
Last Name:BATTANI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:291 E ROUND GROVE RD STE 145
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-3892
Mailing Address - Country:US
Mailing Address - Phone:972-316-3937
Mailing Address - Fax:972-459-9816
Practice Address - Street 1:291 E ROUND GROVE RD STE 145
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-3892
Practice Address - Country:US
Practice Address - Phone:972-316-3937
Practice Address - Fax:972-459-9816
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4412T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX752825794-00OtherSUPERIOR VISION
TX116449OtherEYEMED ECPA
TX752825794-00OtherSUPERIOR VISION
TX00E80WMedicare ID - Type Unspecified