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General NPI Number Information
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NPI Number | 1639249006
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Entity Type | Organization
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Legal Business Name | HAROLD V. JOHNSON, III MD PA
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 02/26/2008
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Provider Practice Location Address
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Address Line | 800 8TH AVE SUITE #412
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City | FORT WORTH
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State | TX
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Zip | 76104-2618
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Country | US
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Telephone | 817-336-0337
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Fax | 817-336-8853
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Provider Business Mailing Address
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Address Line | 800 8TH AVE SUITE #412
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City | FORT WORTH
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State | TX
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Zip | 76104-2601
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Country | US
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Telephone | 817-336-0337
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Fax | 817-336-8853
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HAROLD V. JOHNSON
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Credential | MD
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Telephone | 817-336-0337
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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 | D5048
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License Number State | TX
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