Provider Demographics
NPI:1275610289
Name:AMAN, JANINE C (OD)
Entity Type:Individual
Prefix:
First Name:JANINE
Middle Name:C
Last Name:AMAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2440 E 5TH ST
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-3525
Mailing Address - Country:US
Mailing Address - Phone:903-595-0500
Mailing Address - Fax:903-595-2153
Practice Address - Street 1:608 S PALESTINE ST
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TX
Practice Address - Zip Code:75751-3323
Practice Address - Country:US
Practice Address - Phone:903-675-6440
Practice Address - Fax:903-675-6676
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2015-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5098TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX424909ZPYCMedicare PIN
TXV00199Medicare UPIN
TXV00199Medicare UPIN