Individual
DR. DAVID MICHAEL JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2756 S BROADWAY AVE, TYLER, TX 75701-5412
(903) 593-2345
(903) 593-4646
Mailing address
2756 S BROADWAY AVE, TYLER, TX 75701-5412
(903) 593-2345
(903) 593-4646
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
7283TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
215445201
—
TX
01
—
7283TG
TEXAS OPTOMETRY BOARD
TX
Enumeration date
10/15/2008
Last updated
06/30/2020
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