Organization
MARK JOHNSON, O.D., PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK ALAN JOHNSON O.D. (OPTOMETRIST)
(409) 892-4790
Entity
Organization
Contact information
Practice address
6155 EASTEX FWY, SUITE #699, BEAUMONT, TX 77706-6718
(409) 892-4790
Mailing address
6155 EASTEX FWY, SUITE #699, BEAUMONT, TX 77706-6718
(409) 892-4790
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TX4495
TX
152WC0802X
Corneal and Contact Management Optometrist
TX4495T
TX
156F00000X
Technician/Technologist
TX4495T
TX
156FC0800X
Contact Lens Technician/Technologist
TX4495T
TX
156FC0801X
Contact Lens Fitter
TX4495T
TX
Other
Enumeration date
07/19/2012
Last updated
07/19/2012
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