Individual
BRIAN K SHANDLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
120 HIGHWAY 332 W, STE A5, LAKE JACKSON, TX 77566-4020
(979) 297-8188
(979) 297-5410
Mailing address
120 HIGHWAY 332 W, STE A5, LAKE JACKSON, TX 77566-4020
(979) 297-8188
(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
07/02/2007
Last updated
02/19/2013
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