Moulton, John Stephen
Moulton, John Stephen is an sole proprietor health care provider with primary practice located at 6300 Oakmont Blvd , Ft Worth TX 76132-2813. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Moulton, John Stephen can be contacted via phone (817) 294-2010.Contact Information
Primary practice address
6300 Oakmont Blvd
Ft Worth TX 76132-2813
Phone: (817) 294-2010
Fax: (817) 294-2024
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 3280TG | Texas |
Profile Details
| NPI number | 1174628275 |
|---|---|
| LBN Legal business name | Moulton, John Stephen |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 13th, 2006 |
| Last updated | Jul 9th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174628275 | NPPES |
| Texas | MEDICAID | 917825 |
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