MEDICARE: DR. JAMIE ELIZABETH DANIELIDES OD

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	8138TG	TX

General Provider Information

NPI Number	:	1679909592
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMIE ELIZABETH DANIELIDES OD

Provider Business Mailing Address
First Line	:	2855 GRAMERCY ST STE 400
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77025-1756
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1415 NORTH LOOP W STE 400
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77008-1646
Country	:	US
Telephone Number	:	713-869-6400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/24/2013
Last Update Date	:	03/13/2025

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