Provider Demographics
NPI:1083733893
Name:JODIE L. WEST, O.D., P.A
Entity Type:Organization
Organization Name:JODIE L. WEST, O.D., P.A
Other - Org Name:TEXAS FAMILY EYECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT, OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JODIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:512-260-0405
Mailing Address - Street 1:800 CRYSTAL FALLS PKWY
Mailing Address - Street 2:#4
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641-3666
Mailing Address - Country:US
Mailing Address - Phone:512-260-0405
Mailing Address - Fax:512-260-0425
Practice Address - Street 1:800 CRYSTAL FALLS PKWY
Practice Address - Street 2:#4
Practice Address - City:LEANDER
Practice Address - State:TX
Practice Address - Zip Code:78641-3666
Practice Address - Country:US
Practice Address - Phone:512-260-0405
Practice Address - Fax:512-260-0425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6054TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAETNAOther7774588
TXCIGNAOther625436001
TXEYEMED VISION CAREOther914046
TXNVAOther454320
TXLIFE REOther
TXCLARITY VISIONOther1463587
TXBCBSOther81163Q
TXGREAT WESTOther
TXUNITED HEALTH CAREOther