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Individual

DR. JOHN MCCORMICK JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
12701 RESEARCH BLVD, STE 101, AUSTIN, TX 78759-4325
(512) 258-2020
(512) 258-7835
Mailing address
12701 RESEARCH BLVD, STE 101, AUSTIN, TX 78759-4325
(512) 258-2020
(512) 258-7835

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2621TG
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
121602001
SUPERIOR HEALTH
TX
05
121602001
TX
05
121675601
TX
01
82909E
BCBS PROVIDER ID
TX
Enumeration date
01/09/2007
Last updated
10/13/2010
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