Mark Alan Johnson, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

TX4495T Issued in TX

Practice address

6155 Eastex Fwy
Suite 699
Beaumont, TX 77706-6718

Phone

(409) 892-1284

NPI assigned

Apr 12, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891919023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 OAKLEIGH BLVD",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777067635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6155 EASTEX FWY",
            "address_2": "SUITE 699",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777066718",
            "telephone_number": "409-892-1284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MARK",
        "middle_name": "ALAN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "TX4495T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra Johnson
• Demeka Rashay Johnson
• Etoy Johnson
• Jamie Johnson
• Latrisha Ann Johnson, CPHT
• Raleigh Francis Johnson III, MD
• Sharae Johnson, M.D.
• Takayla Johnson
• Valerie Johnson, PA
• Kaitlyn Joines, BCBA

• Optometrist in Beaumont, TX
• Providers in Beaumont, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.