Provider Demographics
NPI:1891058202
Name:ASKEW, JOHNETTA DENISE
Entity Type:Individual
Prefix:MS
First Name:JOHNETTA
Middle Name:DENISE
Last Name:ASKEW
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:JOHNETTA
Other - Middle Name:
Other - Last Name:ASKEW
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:14800 ENTERPRISE DR
Mailing Address - Street 2:APT 5D
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-2400
Mailing Address - Country:US
Mailing Address - Phone:915-240-9498
Mailing Address - Fax:
Practice Address - Street 1:2630 N JOSEY LN STE 111
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-5541
Practice Address - Country:US
Practice Address - Phone:972-695-5051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-20
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8616T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist