Provider Demographics
NPI:1083809396
Name:JANA HARRELL PONDER OD PLLC
Entity Type:Organization
Organization Name:JANA HARRELL PONDER OD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JANA
Authorized Official - Middle Name:H
Authorized Official - Last Name:PONDER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:903-927-2861
Mailing Address - Street 1:1701 E END BLVD N
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:TX
Mailing Address - Zip Code:75670-0713
Mailing Address - Country:US
Mailing Address - Phone:903-927-2861
Mailing Address - Fax:903-927-2862
Practice Address - Street 1:1701 E END BLVD N
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:TX
Practice Address - Zip Code:75670-0713
Practice Address - Country:US
Practice Address - Phone:903-927-2861
Practice Address - Fax:903-927-2862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty