Provider Demographics
NPI:1447420856
Name:ROBERT L. JONES O.D., P,A.
Entity Type:Organization
Organization Name:ROBERT L. JONES O.D., P,A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:817-284-0798
Mailing Address - Street 1:613 UPTOWN BLVD
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-3511
Mailing Address - Country:US
Mailing Address - Phone:972-291-5757
Mailing Address - Fax:972-291-5756
Practice Address - Street 1:613 UPTOWN BLVD
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-3511
Practice Address - Country:US
Practice Address - Phone:972-291-5757
Practice Address - Fax:972-291-5756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-03
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4279TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXT95913Medicare UPIN
8F1091Medicare PIN
00456ZMedicare PIN