Provider Demographics
NPI:1811327158
Name:ISMAILY, REHNA KIRAN (OD)
Entity type:Individual
Prefix:
First Name:REHNA
Middle Name:KIRAN
Last Name:ISMAILY
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 1:4096 N FOSTER RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78244-1874
Mailing Address - Country:US
Mailing Address - Phone:210-973-6885
Mailing Address - Fax:210-610-5098
Practice Address - Street 1:4096 N FOSTER RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78244
Practice Address - Country:US
Practice Address - Phone:210-973-6885
Practice Address - Fax:210-610-5098
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-22
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8306T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist