Provider Demographics
NPI:1962405134
Name:DANSON, JEREMY LIAM (OD)
Entity type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:LIAM
Last Name:DANSON
Suffix:
Gender:
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 426
Mailing Address - Street 2:
Mailing Address - City:BURNET
Mailing Address - State:TX
Mailing Address - Zip Code:78611-0426
Mailing Address - Country:US
Mailing Address - Phone:512-756-2131
Mailing Address - Fax:512-756-7831
Practice Address - Street 1:2801 S WATER ST
Practice Address - Street 2:
Practice Address - City:BURNET
Practice Address - State:TX
Practice Address - Zip Code:78611-4515
Practice Address - Country:US
Practice Address - Phone:512-756-2131
Practice Address - Fax:512-756-7831
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5773TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX148280402Medicaid
TXP00404716OtherPALMETTO GBA RAILROAD MED
TXP00404716OtherPALMETTO GBA RAILROAD MED
TX5991310001Medicare NSC
TXU75775Medicare UPIN