=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528175551
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOSEPH A JANES O.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/24/2006
-----------------------------------------------------
Last Update Date | 03/07/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 15999 CITY WALK SUITE 270
-----------------------------------------------------
City | SUGARLAND
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77479
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-580-2525
-----------------------------------------------------
Fax | 281-265-1377
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 18850 S. MEMORIAL BLVD
-----------------------------------------------------
City | HUMBLE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77338
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-446-7900
-----------------------------------------------------
Fax | 281-446-4879
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | 02351TG
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------