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NPI Code Detail

MEDICARE: BRYAN S JOHNSON PA-C

MEDICARE: BRYAN S JOHNSON PA-C
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
1363AS0400XSurgical Physician AssistantPA04205TX
2363A00000XPhysician AssistantPA04205TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1598732737
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRYAN S JOHNSON PA-C
Provider Business Mailing Address
First Line : 2000 S MAYS ST STE 201
Second Line :
City : ROUND ROCK
State : TX
Zip : 78664-7580
Country : US
Telephone Number : 512-244-4272
Fax Number : 512-244-2895
Provider Business Practice Location Address
First Line : 2000 S MAYS ST STE 201
Second Line :
City : ROUND ROCK
State : TX
Zip : 78664-7580
Country : US
Telephone Number : 512-244-4272
Fax Number : 512-244-2895
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/07/2006
Last Update Date : 04/13/2021

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Directions to “ BRYAN S JOHNSON PA-C” Practice Location

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