Provider Demographics
NPI:1184616922
Name:JARRETT, ALAN (MD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:
Last Name:JARRETT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:902 FROSTWOOD DR
Mailing Address - Street 2:SUITE 146
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2401
Mailing Address - Country:US
Mailing Address - Phone:713-461-1169
Mailing Address - Fax:713-461-4933
Practice Address - Street 1:902 FROSTWOOD DR
Practice Address - Street 2:SUITE 146
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2401
Practice Address - Country:US
Practice Address - Phone:713-461-1169
Practice Address - Fax:713-461-4933
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-18
Last Update Date:2012-07-20
Deactivation Date:2006-03-23
Deactivation Code:
Reactivation Date:2006-03-28
Provider Licenses
StateLicense IDTaxonomies
TXD7997207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00M020OtherBLUE CROSS BLUE SHIELD
TX034770001Medicaid
TX034770001Medicaid
TX0390590001Medicare NSC
TXTXB2103804Medicare PIN