Provider Demographics
NPI:1144291725
Name:HARRIS SZABO, JO ROBIN (OD)
Entity type:Individual
Prefix:
First Name:JO ROBIN
Middle Name:
Last Name:HARRIS SZABO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:JO ROBIN
Other - Middle Name:
Other - Last Name:SZABO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:14700 FM 2100 RD
Mailing Address - Street 2:STE 3
Mailing Address - City:CROSBY
Mailing Address - State:TX
Mailing Address - Zip Code:77532-9161
Mailing Address - Country:US
Mailing Address - Phone:281-328-2020
Mailing Address - Fax:281-328-8394
Practice Address - Street 1:14700 FM 2100 RD
Practice Address - Street 2:STE 3
Practice Address - City:CROSBY
Practice Address - State:TX
Practice Address - Zip Code:77532-9161
Practice Address - Country:US
Practice Address - Phone:281-328-2020
Practice Address - Fax:281-328-8394
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-31
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5861T.G.152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU81009Medicare UPIN
TXTXB155921Medicare PIN
TX00948EMedicare PIN
TX410046001Medicare PIN
TXP00719879Medicare PIN