Provider Demographics
NPI:1770189961
Name:TRAWNIK, JOHN (BCO)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:TRAWNIK
Suffix:
Gender:M
Credentials:BCO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4600 GREENVILLE AVE STE 240
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-5037
Mailing Address - Country:US
Mailing Address - Phone:214-739-5355
Mailing Address - Fax:214-739-8261
Practice Address - Street 1:4600 GREENVILLE AVE STE 240
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75206-5037
Practice Address - Country:US
Practice Address - Phone:214-739-5355
Practice Address - Fax:214-739-8261
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-11
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1700XEye and Vision Services ProvidersTechnician/TechnologistOcularist