Provider Demographics
NPI:1831218171
Name:PRESCOTT, JASON ALAN (OD)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:ALAN
Last Name:PRESCOTT
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:16535 SOUTHWEST FWY
Mailing Address - Street 2:790
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-2321
Mailing Address - Country:US
Mailing Address - Phone:281-491-2030
Mailing Address - Fax:281-491-2050
Practice Address - Street 1:16535 SOUTHWEST FWY
Practice Address - Street 2:790
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-2321
Practice Address - Country:US
Practice Address - Phone:281-491-2030
Practice Address - Fax:281-491-2050
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2011-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6974T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX212079201Medicaid
TX212079201Medicaid
TX8F24400Medicare PIN