Individual
JELITA ANN GREEN-DATHORNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
2636 S LOOP W, STE 500, HOUSTON, TX 77054-2953
(713) 790-0513
Mailing address
2636 S LOOP W, STE 500, HOUSTON, TX 77054-2953
(281) 354-1538
(281) 354-1733
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
07460TG
TX
Other
Enumeration date
03/02/2010
Last updated
08/08/2016
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