Provider Demographics
NPI:1184216848
Name:JEONG, JEFFREY JINO (OD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:JINO
Last Name:JEONG
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:21502 MERCHANTS WAY STE A
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-2515
Mailing Address - Country:US
Mailing Address - Phone:281-944-2232
Mailing Address - Fax:281-944-2290
Practice Address - Street 1:21502 MERCHANTS WAY STE A
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-2515
Practice Address - Country:US
Practice Address - Phone:281-579-6777
Practice Address - Fax:281-578-6534
Is Sole Proprietor?:No
Enumeration Date:2021-02-04
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10183T152W00000X
TX10183TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist