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Individual

DR. O A WATSON JR.

Active
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Individual

DR. O A WATSON JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Taxonomy

Speciality
Code
Description
License number
State
152WV0400X
Vision Therapy Optometrist
Primary
2196T
TX
152WV0400X
Vision Therapy Optometrist
2470
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00E89B
BLUE CROSS BLUE SHIELD
TX
01
5123963737
VSP
TX
Enumeration date
10/04/2005
Last updated
06/12/2008
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