Provider Demographics
NPI:1740827435
Name:ATASHI RANG GHASSEM PC
Entity type:Organization
Organization Name:ATASHI RANG GHASSEM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GHASSEM
Authorized Official - Middle Name:K
Authorized Official - Last Name:ATASHIRANG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:214-381-1700
Mailing Address - Street 1:2130 S BUCKNER BLVD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75227-8601
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2130 S BUCKNER BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75227-8601
Practice Address - Country:US
Practice Address - Phone:214-381-1700
Practice Address - Fax:214-381-1497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-02
Last Update Date:2019-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty