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Individual

DR. JOHN CLARK MOFFETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
1514 E BELT LINE RD, CARROLLTON, TX 75006-6369
(972) 242-2020
(214) 553-9902
Mailing address
8403 FLOWER MEADOW DR, DALLAS, TX 75243-7423
(214) 553-9900
(214) 553-9902

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
02501
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
02501
LICENCE
TX
Enumeration date
06/04/2007
Last updated
07/08/2007
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