Provider Demographics
NPI:1205821311
Name:PANZER, ALLAN J (OD)
Entity Type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:J
Last Name:PANZER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:DR
Other - First Name:ALLAN
Other - Middle Name:J
Other - Last Name:PANZER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:4760 BEECHNUT ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77096-1637
Mailing Address - Country:US
Mailing Address - Phone:713-664-4760
Mailing Address - Fax:713-665-4760
Practice Address - Street 1:4760 BEECHNUT ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77096-1637
Practice Address - Country:US
Practice Address - Phone:713-664-4760
Practice Address - Fax:713-665-4760
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2012-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2627TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXT15155Medicare UPIN
TXTXB144815Medicare PIN