Provider Demographics
NPI:1174674626
Name:JOHNSON, MURRAY H (OD, MS, FAAO)
Entity Type:Individual
Prefix:DR
First Name:MURRAY
Middle Name:H
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:OD, MS, FAAO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18111 PRESTON RD
Mailing Address - Street 2:SUITE 180
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75252-5470
Mailing Address - Country:US
Mailing Address - Phone:972-248-0202
Mailing Address - Fax:972-248-1711
Practice Address - Street 1:18111 PRESTON RD
Practice Address - Street 2:SUITE 180
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75252-5470
Practice Address - Country:US
Practice Address - Phone:972-248-0202
Practice Address - Fax:972-248-1711
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3129TG152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00E58CMedicare ID - Type Unspecified