Basic Information
| Provider Information | |||||||||
| NPI: | 1780170019 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PANDHER | ||||||||
| FirstName: | TEJVEER | ||||||||
| MiddleName: | SINGH | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | OD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10827 6 AVE SW | ||||||||
| Address2: | |||||||||
| City: | EDMONTON | ||||||||
| State: | ALBERTA | ||||||||
| PostalCode: | T6W1G3 | ||||||||
| CountryCode: | CA | ||||||||
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| Practice Location | |||||||||
| Address1: | 5311 SHERIDAN ST | ||||||||
| Address2: | |||||||||
| City: | HOLLYWOOD | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330213342 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9549617263 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2018 | ||||||||
| LastUpdateDate: | 07/10/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | OPC5561 | FL | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.