Provider Demographics
NPI:1417976564
Name:JOHN K HARDY, OD PA
Entity Type:Organization
Organization Name:JOHN K HARDY, OD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:K
Authorized Official - Last Name:HARDY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:830-624-8870
Mailing Address - Street 1:848 N WALNUT AVE
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-5431
Mailing Address - Country:US
Mailing Address - Phone:830-624-8870
Mailing Address - Fax:830-624-8868
Practice Address - Street 1:848 N WALNUT AVE
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-5431
Practice Address - Country:US
Practice Address - Phone:830-624-8870
Practice Address - Fax:830-624-8868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00148YMedicare ID - Type UnspecifiedGROUP ID
TXT13683Medicare UPIN