Provider Demographics
NPI:1043334063
Name:HYDER, JERRY DUANE (OD)
Entity type:Individual
Prefix:DR
First Name:JERRY
Middle Name:DUANE
Last Name:HYDER
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:515 BAY AREA BLVD
Mailing Address - Street 2:300
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-2602
Mailing Address - Country:US
Mailing Address - Phone:281-488-0066
Mailing Address - Fax:281-488-0601
Practice Address - Street 1:515 BAY AREA BLVD
Practice Address - Street 2:300
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-2602
Practice Address - Country:US
Practice Address - Phone:281-488-0066
Practice Address - Fax:281-488-0601
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX3183T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist