Provider Demographics
NPI:1841518628
Name:NASSER PLLC
Entity type:Organization
Organization Name:NASSER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OD
Authorized Official - Prefix:
Authorized Official - First Name:FARAH
Authorized Official - Middle Name:A
Authorized Official - Last Name:NASSER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:281-392-7890
Mailing Address - Street 1:23501 CINCO RANCH BLVD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-3095
Mailing Address - Country:US
Mailing Address - Phone:281-392-7890
Mailing Address - Fax:713-995-0548
Practice Address - Street 1:23501 CINCO RANCH BLVD
Practice Address - Street 2:SUITE 120
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-3095
Practice Address - Country:US
Practice Address - Phone:281-392-7890
Practice Address - Fax:713-995-0548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-04
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7158T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7158TOtherOPTOMETRY LICENSE
TX=========OtherEMPLOYER IDENTIFICATION NUMBER