Provider Demographics
NPI:1114166634
Name:JONADIA, INC.
Entity Type:Organization
Organization Name:JONADIA, INC.
Other - Org Name:PEARLE VISION GALLERIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR OF OPTOMETRY
Authorized Official - Prefix:
Authorized Official - First Name:NADIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:SLEDGE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:713-623-4181
Mailing Address - Street 1:1800 POST OAK BLVD STE 6120
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-3966
Mailing Address - Country:US
Mailing Address - Phone:713-623-4181
Mailing Address - Fax:713-623-8429
Practice Address - Street 1:1800 POST OAK BLVD STE 6120
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-3966
Practice Address - Country:US
Practice Address - Phone:713-623-4181
Practice Address - Fax:713-623-8429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-05
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5361T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5361TOtherOPTOMETRY LICENSE