Individual
DR. JOHN PAUL TAVARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2677 WILCREST DR, HOUSTON, TX 77042-3211
(713) 977-1170
(713) 977-3327
Mailing address
2470 GRAY FALLS DR STE 150, HOUSTON, TX 77077-6525
(281) 556-5353
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
6418TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1690075-01
—
TX
05
—
1690075-02
—
TX
05
—
169007504
—
TX
Enumeration date
02/21/2006
Last updated
09/25/2012
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