Provider Demographics
NPI:1174054860
Name:BATLIWALA, SHEHZAD Y (DO)
Entity type:Individual
Prefix:
First Name:SHEHZAD
Middle Name:Y
Last Name:BATLIWALA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22715 E 102ND PL S
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74014-2473
Mailing Address - Country:US
Mailing Address - Phone:903-262-7212
Mailing Address - Fax:
Practice Address - Street 1:10010 E 81ST ST STE 100
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-4558
Practice Address - Country:US
Practice Address - Phone:918-250-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-23
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6361207W00000X
TXT5827207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology