Provider Demographics
NPI:1265680326
Name:VIEYRA, JEANETTE (OPTICIAN)
Entity Type:Individual
Prefix:
First Name:JEANETTE
Middle Name:
Last Name:VIEYRA
Suffix:
Gender:F
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23128 FM 1314 RD
Mailing Address - Street 2:
Mailing Address - City:PORTER
Mailing Address - State:TX
Mailing Address - Zip Code:77365-3707
Mailing Address - Country:US
Mailing Address - Phone:281-354-0900
Mailing Address - Fax:281-354-1733
Practice Address - Street 1:23128 FM 1314 RD
Practice Address - Street 2:
Practice Address - City:PORTER
Practice Address - State:TX
Practice Address - Zip Code:77365-3707
Practice Address - Country:US
Practice Address - Phone:281-354-0900
Practice Address - Fax:281-354-1733
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-03
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX208691003156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician