Individual
JOHN LESLIE BASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
3000 S HULEN ST, STE 104, FORT WORTH, TX 76109-1930
(817) 738-2027
(817) 738-5440
Mailing address
3000 S HULEN ST, STE 104, FORT WORTH, TX 76109-1930
(817) 738-2027
(817) 738-5440
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
05099T
TX
Other
Enumeration date
08/31/2006
Last updated
09/12/2011
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