Individual
DR. MALLORY JAYNE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
590 MEDICAL CENTER RD, BLDG 36065, FORT CAVAZOS, TX 76544
(254) 288-8000
Mailing address
2308 LOS ARBOLES LN, WACO, TX 76711-1188
(254) 366-5526
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
6490
FL
Other
Enumeration date
08/13/2024
Last updated
08/13/2024
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