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General NPI Number Information
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NPI Number | 1083733893
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Entity Type | Organization
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Legal Business Name | JODIE L. WEST, O.D., P.A
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 800 CRYSTAL FALLS PKWY #4
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City | LEANDER
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State | TX
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Zip | 78641-3666
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Country | US
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Telephone | 512-260-0405
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Fax | 512-260-0425
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Provider Business Mailing Address
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Address Line | 800 CRYSTAL FALLS PKWY #4
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City | LEANDER
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State | TX
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Zip | 78641-3666
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Country | US
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Telephone | 512-260-0405
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Fax | 512-260-0425
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Authorized Official
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Title or Position | PRESIDENT, OPTOMETRIST
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Name | DR. JODIE L WEST
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Credential | O.D.
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Telephone | 512-260-0405
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 6054TG
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License Number State | TX
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