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Organization
MINI JOHN OD PLLC
Active
Organization
MINI JOHN OD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MINI JOHN OD (OWNER/OD)
(281) 300-2109
Entity
Organization
Contact information
Practice address
2755 TEXAS PKWY, MISSOURI CITY, TX 77489-5105
(281) 300-2109
(713) 995-0548
Mailing address
2755 TEXAS PKWY, MISSOURI CITY, TX 77489-5105
(281) 300-2109
(713) 995-0548
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
6184TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6184TG
TEXAS OPTOMETRY LICENSE
TX
Enumeration date
07/09/2010
Last updated
01/26/2012
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