Provider Demographics
NPI:1396730107
Name:JOSEPH, JIMMY V (OD)
Entity type:Individual
Prefix:DR
First Name:JIMMY
Middle Name:V
Last Name:JOSEPH
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:6210 DUKE TRAIL LN
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-4465
Mailing Address - Country:US
Mailing Address - Phone:215-479-9112
Mailing Address - Fax:281-286-4344
Practice Address - Street 1:6026 HIGHWAY 6
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-4163
Practice Address - Country:US
Practice Address - Phone:281-499-2600
Practice Address - Fax:281-499-6556
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-19
Last Update Date:2013-10-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX6785TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist