Kevin Russell Johnson PA-C

NPI 1194745877 - Physician Assistant - 363A00000X

NPI Details
NPI 1194745877
Gender Male
Enumeration Date 07/19/2006
Last Updated 09/05/2012
Entity Type Individual
Active Over 10 years ago
Practice Location
5201 HARRY HINES BLVD
DALLAS TX, 75235-7708, US
Phone (817) 343-0431
Fax
Business Location
5541 GOODWIN AVE
DALLAS TX, 75206-6212, US
Phone (817) 343-0431
Fax
Toxanomy
Taxonomy Code 363A00000X
License State Texas
License Number PA04026
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According to our database, Mr. Kevin Russell Johnson PA-C NPI is 1194745877, taxonomy code is 363A00000X and license number is PA04026, license state is located at Texas. Kevin Russell Johnson PA-C physically located at 5201 Harry Hines Blvd, Dallas TX, 75235-7708. NPI Number Kevin Russell Johnson PA-C has the Individual type.

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1194745877 NPI number is provided on an as is basis without warranty of any kind. 1194745877 is maintained by the National Plan & Provider Enumeration System. The contents of Kevin Russell Johnson PA-C are for informational purposes only.