Provider Demographics
NPI:1649844572
Name:JOHN STUART, JR., OD, PLLC
Entity type:Organization
Organization Name:JOHN STUART, JR., OD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:STUART
Authorized Official - Suffix:JR
Authorized Official - Credentials:OD
Authorized Official - Phone:972-685-2888
Mailing Address - Street 1:12820 HILLCREST RD STE 100
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-1516
Mailing Address - Country:US
Mailing Address - Phone:972-685-2888
Mailing Address - Fax:
Practice Address - Street 1:12820 HILLCREST RD STE 100
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-1516
Practice Address - Country:US
Practice Address - Phone:972-685-2888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-15
Last Update Date:2021-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty