Healthcare Provider Details

I. General information

NPI: 1427675073
Provider Name (Legal Business Name): TXO 2 0 PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2020
Last Update Date: 09/14/2023
Certification Date: 09/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 ELM ST STE LL20
DALLAS TX
75270-2029
US

IV. Provider business mailing address

1201 ELM ST STE LL20
DALLAS TX
75270-2029
US

V. Phone/Fax

Practice location:
  • Phone: 214-651-1000
  • Fax: 214-665-1000
Mailing address:
  • Phone: 214-651-1000
  • Fax: 214-651-1000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: JOHN JOHNSON
Title or Position: OFFICER
Credential: OD
Phone: 785-845-9655