Individual
SOROUSH BAHNAMIRI AZADI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
4211 S LAMAR BLVD, STE E-3, AUSTIN, TX 78704-7996
(512) 916-4600
Mailing address
4211 S LAMAR BLVD, STE E-3, AUSTIN, TX 78704-7996
(512) 916-4600
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
6642TG
TX
Other
Enumeration date
08/05/2006
Last updated
09/12/2012
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