Organization
JOHN TODD CORNETTOD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN TODD P CORNETT OD PA (PRESIDENT)
(806) 356-6868
Entity
Organization
Contact information
Practice address
3635 SONCY, AMARILLO, TX 79119
(806) 368-6868
(806) 351-0120
Mailing address
3635 SONCY, AMARILLO, TX 79119
(806) 368-6868
(806) 351-0120
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4625TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0071PW
BCBS
TX
05
—
019422701
—
TX
01
—
DG014
RAILROAD
TX
Enumeration date
08/24/2006
Last updated
01/10/2019
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