Healthcare Provider Details

I. General information

NPI: 1336559509
Provider Name (Legal Business Name): LESSIE JOHNSON FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2014
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8144 WALNUT HILL LN SUITE 1120
DALLAS TX
75231-4388
US

IV. Provider business mailing address

8144 WALNUT HILL LANE SUITE 1120
DALLAS TX
75231
US

V. Phone/Fax

Practice location:
  • Phone: 214-785-2200
  • Fax: 877-885-9904
Mailing address:
  • Phone: 214-785-2200
  • Fax: 877-885-9904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number736075
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number226127
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: