Provider Demographics
NPI:1184946287
Name:BAXTER, JESSICA A (OD)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:A
Last Name:BAXTER
Suffix:
Gender:
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:12402 SAN LUCIA RIVER DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77050-3832
Mailing Address - Country:US
Mailing Address - Phone:936-568-0219
Mailing Address - Fax:936-560-4252
Practice Address - Street 1:20131 HIGHWAY 59 N STE 1250
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-2332
Practice Address - Country:US
Practice Address - Phone:346-384-8077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-17
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7442TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist