Individual
DR. JOHN STEPHEN MOULTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
6300 OAKMONT BLVD, FT WORTH, TX 76132-2813
(817) 294-2010
(817) 294-2024
Mailing address
721 LAKE VIEW DR, CROWLEY, TX 76036-3957
(817) 426-4240
(817) 426-3654
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3280TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
917825
—
TX
Enumeration date
09/13/2006
Last updated
07/09/2007
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