Provider Demographics
NPI:1144498684
Name:ALAN JARRETT M.D.P.A.
Entity type:Organization
Organization Name:ALAN JARRETT M.D.P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:JARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:MDPA
Authorized Official - Phone:713-461-1169
Mailing Address - Street 1:902 FROSTWOOD DR
Mailing Address - Street 2:SUITE 146
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2401
Mailing Address - Country:US
Mailing Address - Phone:713-461-1169
Mailing Address - Fax:
Practice Address - Street 1:902 FROSTWOOD DR
Practice Address - Street 2:SUITE 146
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2401
Practice Address - Country:US
Practice Address - Phone:713-461-1169
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2012-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD7997332H00000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
No332H00000XSuppliersEyewear SupplierGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00M020OtherBLUE CROSS BLUE SHIELD
TX034770001Medicaid
TXTXB2103803Medicare PIN
TX00M020OtherBLUE CROSS BLUE SHIELD
TX00M020Medicare Oscar/Certification