Provider Demographics
NPI:1407845597
Name:FLANDERS, ROBERT WILLIAM (OD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:WILLIAM
Last Name:FLANDERS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2366 RICE BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-2666
Mailing Address - Country:US
Mailing Address - Phone:713-521-2020
Mailing Address - Fax:713-521-3727
Practice Address - Street 1:2366 RICE BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77005-2666
Practice Address - Country:US
Practice Address - Phone:713-521-2020
Practice Address - Fax:713-521-3727
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3787 TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00E83EOtherBCBS
TX80564QOtherBCBS
TXE83EMedicare ID - Type Unspecified
TX80564QOtherBCBS