Individual
MR. JUAN JOSE BARAJAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1300 S BRYAN RD, STE 105, MISSION, TX 78572-6688
(956) 581-6151
(956) 581-4836
Mailing address
1300 S BRYAN RD STE 105, MISSION, TX 78572-6688
(956) 581-6151
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5335TG
TX
152WC0802X
Corneal and Contact Management Optometrist
5335TG
TX
152WP0200X
Pediatric Optometrist
5335TG
TX
152WV0400X
Vision Therapy Optometrist
5335TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102202203
—
TX
01
—
80302Q
BCBS
TX
Enumeration date
05/24/2005
Last updated
03/11/2014
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