J. David Johnson,Md,Pa
LBN: J. David Johnson,Md,Pa
J. David Johnson,Md,Pa is an health care organization with primary practice located at 618 S Broadway Ave , Tyler TX 75701-1665. The organization recently has only one registered license in Other Service Providers / Specialist, which is considered as the primary health care specialty.
J. David Johnson,Md,Pa can be contacted via phone (903) 596-9900, or through Gordon, James M via phone (903) 596-9900.
Contact Information
Primary practice address
618 S Broadway Ave
Tyler TX 75701-1665
Phone: (903) 596-9900
Fax: (903) 596-0242
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | G7829 | Texas |
| Other Service Providers / Specialist | 174400000X | K4497 | Texas |
Profile Details
| NPI number | 1376747196 |
|---|---|
| LBN Legal business name | J. David Johnson,Md,Pa |
| DBA Doing business as | |
| Authorized official | Gordon, James M NURSE PRACTITIONER |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jun 14th, 2007 |
| Last updated | Jan 28th, 2008 - about 16 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1376747196 | NPPES |
| Texas | MEDICAID | 128264203 |
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