Provider Demographics
NPI:1780992347
Name:MEHDIRATTA, NISHI (OD)
Entity type:Individual
Prefix:DR
First Name:NISHI
Middle Name:
Last Name:MEHDIRATTA
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 1:2019 W GRAY ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77019-3601
Mailing Address - Country:US
Mailing Address - Phone:135-280-1767
Mailing Address - Fax:
Practice Address - Street 1:3636 GREENBRIAR DR STE 200B
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-2049
Practice Address - Country:US
Practice Address - Phone:832-410-1422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-16
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7572TG152W00000X
CA13967152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist