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General NPI Number Information
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NPI Number | 1174450019
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Entity Type | Organization
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Legal Business Name | FOUR JOHNSON FOUNDATION
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Dates
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Enumeration Date | 05/05/2026
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Last Update Date | 05/05/2026
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Provider Practice Location Address
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Address Line | 1801 N HAMPTON RD STE 360
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City | DESOTO
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State | TX
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Zip | 75115-8308
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Country | US
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Telephone | 972-282-4842
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Fax |
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Provider Business Mailing Address
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Address Line | 1007 FAIRBANKS DR
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City | ENNIS
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State | TX
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Zip | 75119-1836
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SITE LEADER
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Name | LAURI JOHNSON
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Credential |
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Telephone | 972-282-4842
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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