Provider Demographics
NPI:1508070525
Name:ALSHEIKH, ODAY J (MD)
Entity Type:Individual
Prefix:
First Name:ODAY
Middle Name:J
Last Name:ALSHEIKH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 N MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212-4701
Mailing Address - Country:US
Mailing Address - Phone:210-222-2154
Mailing Address - Fax:210-227-6056
Practice Address - Street 1:1100 N MAIN AVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212-4701
Practice Address - Country:US
Practice Address - Phone:210-222-2154
Practice Address - Fax:210-227-6056
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2017-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX42246207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX195679902Medicaid
TXTXB138203Medicare PIN
TX195679902Medicaid