Provider Demographics
NPI:1992006134
Name:FARIS OHAN
Entity Type:Organization
Organization Name:FARIS OHAN
Other - Org Name:EXCEPTIONAL EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FARIS
Authorized Official - Middle Name:G
Authorized Official - Last Name:OHAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:281-232-8257
Mailing Address - Street 1:2035 FM 359 RD
Mailing Address - Street 2:SUITE 11
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-1115
Mailing Address - Country:US
Mailing Address - Phone:281-232-8257
Mailing Address - Fax:281-232-0894
Practice Address - Street 1:2035 FM 359 RD
Practice Address - Street 2:SUITE 11
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-1115
Practice Address - Country:US
Practice Address - Phone:281-232-8257
Practice Address - Fax:281-232-0894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-04
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6557TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX168288202Medicaid
TX6557TGOtherOTOMETRY LICENSE
TX168288202Medicaid