Organization
BRIAN K. SHANDLEY OD PA
Active
Other names
Texas State Optical
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN SHANDLEY (OWNER)
(979) 297-8188
Entity
Organization
Contact information
Practice address
120 HIGHWAY 332 W, SUITE A5, LAKE JACKSON, TX 77566-4017
(979) 297-3095
(979) 297-5410
Mailing address
120 HIGHWAY 332 W, SUITE A5, LAKE JACKSON, TX 77566-4017
(979) 297-3095
(979) 297-5410
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5022TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
161005701
—
TX
Enumeration date
04/13/2007
Last updated
02/19/2013
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