MEDICARE: SARAH JOSEPH JOHN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	42822T	TX

General Provider Information

NPI Number	:	1124247317
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SARAH JOSEPH JOHN

Provider Business Mailing Address
First Line	:	3000 TOWN EAST MALL
Second Line	:
City	:	MESQUITE
State	:	TX
Zip	:	75150-4120
Country	:	US
Telephone Number	:	972-681-1715
Fax Number	:	972-681-2066

Provider Business Practice Location Address
First Line	:	3000 TOWN EAST MALL
Second Line	:
City	:	MESQUITE
State	:	TX
Zip	:	75150-4120
Country	:	US
Telephone Number	:	972-681-1715
Fax Number	:	972-681-2066

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	SARAH J JOHN
Credential	:	O.D.
Telephone Number	:	972-681-1715

Provider Enumeration Date	:	04/25/2007
Last Update Date	:	08/22/2020

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Directions to “SARAH JOSEPH JOHN ” Practice Location

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