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Individual

DR. JONATHAN LEROY GANDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
3345 PLAZA 10 DR STE B, BEAUMONT, TX 77707-2553
(409) 833-0444
(409) 833-9039
Mailing address
3345 PLAZA 10 DR STE B, BEAUMONT, TX 77707-2553
(409) 833-0009
(409) 833-9039

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
8155T
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8155
OPTOMETRY LICENSE
TX
Enumeration date
07/11/2013
Last updated
11/09/2021
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