Johnson Ly, OD
Optometrist in Plano, TX. Individual provider (NPI-1).
NPI number1164076949
StatusActive
Last updated in NPPESSep 12, 2024
Details
- NPI
- 1164076949
- Entity type
- Individual (NPI-1)
- Name
- Johnson Ly
- Credential
- OD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 30, 2019
- Certification date
- Sep 12, 2024
- Last updated
- Sep 12, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 9736 | TX | Yes |
Practice location
2313 W Parker RdPlano, TX 75023-7839
Phone 972-612-2015 · Fax 972-867-5454
Mailing address
8614 Westwood Center Dr Fl 9Vienna, VA 22182-2442
Phone 703-847-8899 · Fax 571-223-6780
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