Provider Demographics
NPI:1184324378
Name:LOONAT, RAEES (OD)
Entity type:Individual
Prefix:
First Name:RAEES
Middle Name:
Last Name:LOONAT
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 1:2325 S BLAZE TRL
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85748-5127
Mailing Address - Country:US
Mailing Address - Phone:520-245-7847
Mailing Address - Fax:
Practice Address - Street 1:9615 E OLD SPANISH TRL
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85748-7540
Practice Address - Country:US
Practice Address - Phone:520-296-4290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOPT-002672152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist