Provider Demographics
NPI:1952089971
Name:KAZIMI, BATOOL FATIMA (OD)
Entity Type:Individual
Prefix:
First Name:BATOOL
Middle Name:FATIMA
Last Name:KAZIMI
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 1:4401 MARTIN LUTHER KING BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77204-1804
Mailing Address - Country:US
Mailing Address - Phone:713-743-1921
Mailing Address - Fax:713-743-0963
Practice Address - Street 1:2525 LUCAS DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-1804
Practice Address - Country:US
Practice Address - Phone:214-528-1354
Practice Address - Fax:214-528-7387
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10923152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX10923OtherTEXAS OPTOMETRY BOARD