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Individual
SAMIR PATTNI
Active
Individual
SAMIR PATTNI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4757TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0A4530
MEDICARE GROUP PTAN
TX
01
—
8F21704
MEDICARE PTAN INDIVIDUAL
TX
01
—
OOE12Y
MEDICARE PROVIDER NUMBER
TX
Enumeration date
11/14/2005
Last updated
11/01/2012
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