Organization
BOERNE VISION CENTER PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN LY JOHNSON OD (OWNER/AUTHORIZED OFFICIAL)
(830) 331-8745
Entity
Organization
Contact information
Practice address
124 E BANDERA RD, SUITE 403, BOERNE, TX 78006-2849
(830) 331-8745
(830) 331-8749
Mailing address
124 E BANDERA RD, SUITE 403, BOERNE, TX 78006-2849
(830) 331-8745
(830) 331-8749
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
376409401
—
TX
Enumeration date
02/21/2012
Last updated
12/09/2019
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