Provider Demographics
NPI:1841864212
Name:ROMERO, JORDAN RAMSSES (OD)
Entity type:Individual
Prefix:DR
First Name:JORDAN
Middle Name:RAMSSES
Last Name:ROMERO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:18255 RIVER SAGE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-2485
Mailing Address - Country:US
Mailing Address - Phone:832-878-6817
Mailing Address - Fax:
Practice Address - Street 1:200 OGLETREE DR
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:TX
Practice Address - Zip Code:77351-6420
Practice Address - Country:US
Practice Address - Phone:936-328-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-19
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10308TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist