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NPI Code Detail

MEDICARE: JODI FLANAGAN O.D. P.A.

MEDICARE: JODI FLANAGAN O.D. P.A.
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
1152W00000XOptometrist4744TGTX

General Provider Information

NPI Number : 1427075357
Entity Type Code : Organization
Provider Name (Legal Business Name) : JODI FLANAGAN O.D. P.A.
Provider Business Mailing Address
First Line : 655 LOOP 337 APT 305
Second Line : WWW.SCOPERJO@YAHOO.COM
City : NEW BRAUNFELS
State : TX
Zip : 78130-3659
Country : US
Telephone Number : 210-323-5519
Fax Number : 210-666-3744
Provider Business Practice Location Address
First Line : 8315 FM 78
Second Line :
City : CONVERSE
State : TX
Zip : 78109-1043
Country : US
Telephone Number : 210-666-3700
Fax Number : 210-666-3744
Authorized Official
Title or Position : DR./PRESIDENT
Name : DR. JODI FLANAGAN
Credential : O.D.
Telephone Number : 210-666-3700
Provider Enumeration Date : 07/16/2006
Last Update Date : 04/27/2009

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