| NPI | 1376899633 |
|---|---|
| Former Name | JESSICA RENEE GANDY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 8014T) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AR 2678) |
| 152W00000X Optometrist (Licence: OK 2730) | |
| Enumeration Date | 2012-07-24 |
| Last Update Date | 2023-07-03 |