Mark Johnson, O.D., PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

TX4495 Issued in TX

Legal business name

MARK JOHNSON, O.D., PLLC

Practice address

6155 Eastex Fwy
Suite #699
Beaumont, TX 77706-6718

Phone

(409) 892-4790

NPI assigned

Jul 19, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Mark Alan Johnson, O.D.

Title

Optometrist

Phone

(409) 892-4790

Specialties & licenses 5

Addresses

Locations

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

{
    "created_epoch": "1342656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342656000000",
    "number": "1952656589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6155 EASTEX FWY",
            "address_2": "SUITE #699",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777066718",
            "telephone_number": "409-892-4790"
        },
        {
            "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": "409-892-4790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK JOHNSON, O.D., PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-19",
        "last_updated": "2012-07-19",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "409-892-4790",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "TX4495",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "TX",
            "license": "TX4495T",
            "primary": false
        },
        {
            "code": "156F00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist",
            "state": "TX",
            "license": "TX4495T",
            "primary": false
        },
        {
            "code": "156FC0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist, Contact Lens",
            "state": "TX",
            "license": "TX4495T",
            "primary": false
        },
        {
            "code": "156FC0801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist, Contact Lens Fitter",
            "state": "TX",
            "license": "TX4495T",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sidney Albert Marchand IV, M.D.
• Faiza Maredia
• Wayne S Margolis, M.D.
• Mark D. Larson, M.D., P.a.
• Mark J Kubala MD PA
• Eric Adam Marks, MD
• Marsha Geraldine Marks, PTA
• Patricia M Marks, MT
• Sumalai Maroonroge, PH.D.
• Kristi Denise Marsh, CEO

• 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 19, 2012; 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.