Provider Demographics
NPI:1427075357
Name:JODI FLANAGAN O.D. P.A.
Entity type:Organization
Organization Name:JODI FLANAGAN O.D. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR./PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JODI
Authorized Official - Middle Name:
Authorized Official - Last Name:FLANAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:210-666-3700
Mailing Address - Street 1:655 LOOP 337 APT 305
Mailing Address - Street 2:WWW.SCOPERJO@YAHOO.COM
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-3659
Mailing Address - Country:US
Mailing Address - Phone:210-323-5519
Mailing Address - Fax:210-666-3744
Practice Address - Street 1:8315 FM 78
Practice Address - Street 2:
Practice Address - City:CONVERSE
Practice Address - State:TX
Practice Address - Zip Code:78109-1043
Practice Address - Country:US
Practice Address - Phone:210-666-3700
Practice Address - Fax:210-666-3744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2009-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4744TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty