MEDICARE: BRIAN K SHANDLEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	5022TG	TX

General Provider Information

NPI Number	:	1417900036
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIAN K SHANDLEY

Provider Business Mailing Address
First Line	:	120 HWY 332 W
Second Line	:	STE A5
City	:	LAKE JACKSON
State	:	TX
Zip	:	77566-4017
Country	:	US
Telephone Number	:	979-297-8188
Fax Number	:	979-297-5410

Provider Business Practice Location Address
First Line	:	120 HWY 332 W
Second Line	:	STE A5
City	:	LAKE JACKSON
State	:	TX
Zip	:	77566-4017
Country	:	US
Telephone Number	:	979-297-8188
Fax Number	:	979-297-5410

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. TRICIA E SMITH
Credential	:
Telephone Number	:	979-299-8188

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	08/22/2020

Similar Medicare Providers

1326262858 — BRIAN K. SHANDLEY OD PA
Practice Location Address:

120 HIGHWAY 332 W , SUITE A5
LAKE JACKSON, TX
77566-4017

Practice Phone: 979-297-3095
Practice Fax: 979-297-5410

1194055988 — DERBONNE CHIROPRACTIC
Practice Location Address:

120 HIGHWAY 332 W STE A4
LAKE JACKSON, TX
77566-4017

Practice Phone: 979-285-2663
Practice Fax: 979-285-2664

1467938878 — DR. DARRIN C. SHANDLEY OD
Practice Location Address:

120 HIGHWAY 332 W STE A5
LAKE JACKSON, TX
77566-4017

Practice Phone: 979-297-8188
Practice Fax: 979-297-5410

1184790578 — DR. SCOTT E TROUT D.D.S.
Practice Location Address:

4017 W JACKSON ST
MUNCIE, IN
47304-3610

Practice Phone: 765-747-7992
Practice Fax: 765-288-5542

1467233742 — ALWAYS DEVELOPING ABA LLC
Practice Location Address:

214 E JACKSON ST
LANSING, MI
48906-4017

Practice Phone: 702-960-2490
Practice Fax:

1255170932 — ELORA POWELL
Practice Location Address:

1264 JACKSON ST NE
WASHINGTON, DC
20017-4017

Practice Phone: 240-758-6406
Practice Fax:

Directions to “BRIAN K SHANDLEY ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.