Individual
BILAL ISMAIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5832 BOAT CLUB RD, FORT WORTH, TX 76179-7773
(817) 237-7153
(817) 237-7123
Mailing address
1950 OLD GALLOWS RD STE 520, VIENNA, VA 22182-3970
(703) 847-8899
(571) 223-6780
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
10297
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27874011
DRIVERS LICENSE
TX
Enumeration date
04/16/2021
Last updated
06/29/2021
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