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General NPI Number Information
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NPI Number | 1083026132
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Entity Type | Organization
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Legal Business Name | MELISSA ANN JOHNSON, PLLC
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Dates
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Enumeration Date | 05/23/2014
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Last Update Date | 05/23/2014
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Provider Practice Location Address
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Address Line | 212 POLO TRL
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City | COLLEYVILLE
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State | TX
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Zip | 76034-7577
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Country | US
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Telephone | 817-739-5391
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Fax |
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Provider Business Mailing Address
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Address Line | 212 POLO TRL
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City | COLLEYVILLE
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State | TX
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Zip | 76034-7577
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Country | US
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Telephone | 817-739-5391
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Fax |
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Authorized Official
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Title or Position | PHYSCIAN
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Name | DR. MELISSA ANN JOHNSON
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Credential |
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Telephone | 817-739-5391
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | M4217
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License Number State | TX
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