Provider Demographics
NPI:1366778342
Name:MERCHANT, MONA (OD)
Entity type:Individual
Prefix:
First Name:MONA
Middle Name:
Last Name:MERCHANT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:MONA
Other - Middle Name:
Other - Last Name:PUNJWANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:4645 PLANO PKWY APT 2202
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-4946
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:18121 MARSH LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75287-5742
Practice Address - Country:US
Practice Address - Phone:972-862-2262
Practice Address - Fax:972-862-2273
Is Sole Proprietor?:No
Enumeration Date:2009-10-26
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX07246TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist