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Individual

JOHN S MCCOLLOUGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
4406 N LAURENT, VICTORIA, TX 77901-2791
(361) 578-0107
(361) 578-1320
Mailing address
4406 N LAURENT, VICTORIA, TX 77901-2791
(361) 578-0107
(361) 578-1320

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2620T
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
127231206
TX
Enumeration date
11/18/2005
Last updated
08/14/2008
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