Individual
JONATHAN GLENN DESHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2636 W WALNUT ST STE 200, GARLAND, TX 75042-6441
(972) 485-0700
(972) 485-0702
Mailing address
2636 W WALNUT ST STE 200, GARLAND, TX 75042-6441
(972) 485-0700
(972) 485-0702
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
7628TG
TX
Other
Enumeration date
07/28/2010
Last updated
07/22/2011
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