Provider Demographics
NPI:1598331274
Name:JANSON, CHLOE ANN (OD)
Entity Type:Individual
Prefix:
First Name:CHLOE
Middle Name:ANN
Last Name:JANSON
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:PO BOX 207170
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75320-7170
Mailing Address - Country:US
Mailing Address - Phone:636-200-4393
Mailing Address - Fax:636-527-0766
Practice Address - Street 1:8315 BEECHMONT AVE STE 33
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-3193
Practice Address - Country:US
Practice Address - Phone:513-474-4444
Practice Address - Fax:513-474-7915
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-02
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2252DT152W00000X
OHOPT.007003152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist