Provider Demographics
NPI:1396471751
Name:ZAIDI, SUKAINA FATIMA (OD)
Entity type:Individual
Prefix:
First Name:SUKAINA
Middle Name:FATIMA
Last Name:ZAIDI
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 1:6502 GLEN CANYON CT
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-5412
Mailing Address - Country:US
Mailing Address - Phone:734-674-4363
Mailing Address - Fax:
Practice Address - Street 1:26914 FM 1093 RD STE 200
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-3621
Practice Address - Country:US
Practice Address - Phone:346-307-8306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-28
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10487152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist