Provider Demographics
NPI:1881757102
Name:FLANDERS, ALLEN (OD)
Entity type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:
Last Name:FLANDERS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15402 JEWEL LAKE LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77044-2086
Mailing Address - Country:US
Mailing Address - Phone:732-513-2990
Mailing Address - Fax:
Practice Address - Street 1:15402 JEWEL LAKE LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77044-2086
Practice Address - Country:US
Practice Address - Phone:732-513-2990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ4853152W00000X
TX9010T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist