Provider Demographics
NPI:1174142418
Name:ASTANI, SAHAB (OD)
Entity type:Individual
Prefix:DR
First Name:SAHAB
Middle Name:
Last Name:ASTANI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 410108
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64141-0108
Mailing Address - Country:US
Mailing Address - Phone:405-393-2273
Mailing Address - Fax:405-607-6685
Practice Address - Street 1:1851 S KELLY AVE
Practice Address - Street 2:SUITE B
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013
Practice Address - Country:US
Practice Address - Phone:405-393-2273
Practice Address - Fax:405-907-1851
Is Sole Proprietor?:No
Enumeration Date:2020-04-15
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3053152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist