Individual provider Active NPI

Zenah Gheblawi, OD

  • Optometrist
  • Shenandoah, TX
National Provider Identifier
1891471603
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10824T Issued in TX
Practice address
19075 I 45 S Ste 121B
Shenandoah, TX 77385-8772
Phone
(936) 271-1717
NPI assigned
Jun 26, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 10824T TX Primary

Addresses

Primary practice location

19075 I 45 S Ste 121B
Shenandoah, TX 77385-8772

Mailing address

3613 Bonita Ranch CT
Bonita, CA 91902-2714
Phone (714) 393-5343

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
10824TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
National Vision, Inc. PastSince Jul 2, 2023 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1687737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1891471603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3613 BONITA RANCH CT",
            "city": "BONITA",
            "state": "CA",
            "postal_code": "919022714",
            "telephone_number": "714-393-5343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19075 I 45 S STE 121B",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773858772",
            "telephone_number": "936-271-1717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHEBLAWI",
        "first_name": "ZENAH",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-26",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "10824T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shenandoah, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.