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General NPI Number Information
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NPI Number | 1285822957
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Entity Type | Organization
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Legal Business Name | RICHARD JOHNSON MD PA
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Dates
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Enumeration Date | 10/09/2007
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Last Update Date | 10/09/2007
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Provider Practice Location Address
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Address Line | 710 WATER ST STE 300
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City | KERRVILLE
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State | TX
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Zip | 78028-5396
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Country | US
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Telephone | 830-257-5500
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 290968
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City | KERRVILLE
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State | TX
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Zip | 78029-0968
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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 | CREDENTIALING
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Name | CINDY TAYLOR
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Credential |
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Telephone | 830-896-2900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | F1686
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License Number State | TX
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