Individual
LEAH JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5024 BROADWAY, SAN ANTONIO, TX 78209-5708
(512) 396-1500
Mailing address
5024 BROADWAY, SAN ANTONIO, TX 78209-5708
(512) 529-4932
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Enumeration date
12/07/2012
Last updated
08/29/2022
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