Johnson, David O

Johnson, David O is an individual health care provider with primary practice located at 731 E Southlake Blvd Suite 100, Southlake TX 76092-6377. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Johnson, David O can be contacted via phone (817) 912-8800.

Contact Information

Primary practice address
731 E Southlake Blvd Suite 100 Southlake TX 76092-6377
Phone: (817) 912-8800
Fax: (817) 912-8810
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X E4432 Texas

Profile Details

NPI number 1740204692
LBN Legal business name Johnson, David O
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 26th, 2006
Last updated Jun 11th, 2015 - about 9 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740204692 NPPES
Texas MEDICAID 1378663-01
Texas Other 88X564

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