Provider Demographics
NPI:1740313089
Name:JANET B OGLETREE OD PA
Entity type:Organization
Organization Name:JANET B OGLETREE OD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JANET
Authorized Official - Middle Name:B
Authorized Official - Last Name:OGLETREE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:972-355-5152
Mailing Address - Street 1:3551 JUSTIN RD STE 150
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-6213
Mailing Address - Country:US
Mailing Address - Phone:972-355-5152
Mailing Address - Fax:972-691-2958
Practice Address - Street 1:3551 JUSTIN RD STE 150
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-6213
Practice Address - Country:US
Practice Address - Phone:972-355-5152
Practice Address - Fax:972-691-2958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2014-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5710TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6787910001Medicare NSC
TXU79191Medicare UPIN