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Individual

MARK ALAN JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
6155 EASTEX FWY, SUITE 699, BEAUMONT, TX 77706-6718
(409) 892-1284
Mailing address
3 OAKLEIGH BLVD, BEAUMONT, TX 77706-7635

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TX4495T
TX

Other

Enumeration date
04/12/2007
Last updated
07/08/2007
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