Provider Demographics
NPI:1871523464
Name:JENKINS, DANIEL E III (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:E
Last Name:JENKINS
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HARRISBURG EYE CLINIC
Mailing Address - Street 2:7438 HARRISBURG BLVD
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77011-4741
Mailing Address - Country:US
Mailing Address - Phone:713-928-3375
Mailing Address - Fax:713-928-6173
Practice Address - Street 1:7438 HARRISBURG BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77011-4741
Practice Address - Country:US
Practice Address - Phone:713-928-3375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD9023207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX082179501Medicaid
TX00DG87Medicare ID - Type Unspecified
TXC17430Medicare UPIN