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General NPI Number Information
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NPI Number | 1093063323
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Entity Type | Individual
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Provider Name | CHARLES ALEXANDER JOHNSON PHARMD
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Gender | Male
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Dates
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Enumeration Date | 08/16/2012
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Last Update Date | 08/16/2012
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Provider Practice Location Address
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Address Line | 3030 W MAIN ST
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City | FRISCO
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State | TX
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Zip | 75033-4317
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Country | US
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Telephone | 214-387-8743
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Fax |
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Provider Business Mailing Address
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Address Line | 3400 CRAIG DR APT 118
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City | MCKINNEY
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State | TX
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Zip | 75070-4510
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Country | US
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Telephone | 865-208-1060
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 52068
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License Number State | TX
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