MEDICARE: STEPHEN JOHNSTON MD

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
1	207RC0000X	Cardiovascular Disease Physician	F9632	TX

General Provider Information

NPI Number	:	1831163153
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN JOHNSTON MD

Provider Business Mailing Address
First Line	:	3417 GASTON AVE STE 700
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75246-2031
Country	:	US
Telephone Number	:	972-993-5000
Fax Number	:	972-993-5001

Provider Business Practice Location Address
First Line	:	8222 DOUGLAS AVE STE 600
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75225-5937
Country	:	US
Telephone Number	:	972-993-5040
Fax Number	:	972-993-5041

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/14/2006
Last Update Date	:	11/07/2024

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