Individual
MR. JOHN K DEATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1424 EAST FRONT, TYLER, TX 75702-8501
(903) 595-4144
(903) 596-7541
Mailing address
PO BOX 130639, TYLER, TX 75713-0639
(903) 595-4167
(903) 596-7541
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
05562TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
047945301
—
TX
05
—
047945302
—
TX
01
—
1964984
UNITED HEALTHCARE
TX
01
—
21816989
FIRST HEALTH
TX
01
—
7009226
AETNA
TX
01
—
70893
MEDICARE
TX
01
—
80154Q
BLUE CROSS BLUE SHIELD
TX
01
—
9942374
CIGNA
TX
01
—
P02098771
MEDICARE RAIL ROAD
TX
Enumeration date
07/07/2005
Last updated
11/06/2018
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