Brian K Shandley, OD Valid NPI
Individual provider · Optometrist · Lake Jackson, TX
- NPI
- 1912104969
- Type
- Individual (Type 1)
- Primary specialty
- Optometrist
- Specialty group
- Eye and Vision Services Providers
- Taxonomy code
- 152W00000X
- License number
- 5022TG (TX)
- Sex
- Male
- Sole proprietor
- Yes
- Enumerated
- 2007-07-02
- Last updated
- 2013-02-19
Practice location
120 Highway 332 W, Ste A5
Lake Jackson, TX 77566-4020
(979) 297-8188