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NPI Code Detail

MEDICARE: DR. RAY MONROE JOHNSON M.D.

MEDICARE: DR. RAY MONROE JOHNSON M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics PhysicianH9098TX

General Provider Information

NPI Number : 1235139056
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RAY MONROE JOHNSON M.D.
Provider Business Mailing Address
First Line : 200 NOLA RUTH BLVD
Second Line :
City : HARKER HEIGHTS
State : TX
Zip : 76548-6074
Country : US
Telephone Number : 254-698-6629
Fax Number : 254-698-1673
Provider Business Practice Location Address
First Line : 200 NOLA RUTH BLVD
Second Line :
City : HARKER HEIGHTS
State : TX
Zip : 76548-6074
Country : US
Telephone Number : 254-698-6628
Fax Number : 254-698-1673
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2005
Last Update Date : 07/16/2007

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