Shandley, Brian K

Shandley, Brian K is an sole proprietor health care provider with primary practice located at 120 Highway 332 W Ste A5, Lake Jackson TX 77566-4020. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Shandley, Brian K can be contacted via phone (979) 297-8188.

Contact Information

Primary practice address
120 Highway 332 W Ste A5 Lake Jackson TX 77566-4020
Fax: (979) 297-5410
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 5022TG Texas

Profile Details

NPI number 1912104969
LBN Legal business name Shandley, Brian K
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 2nd, 2007
Last updated Feb 19th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912104969 NPPES
Texas MEDICAID 161005701

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