MEDICARE: MR. JAMES G. JOHNSON JAMES JOHNSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor
2	101YP2500X	Professional Counselor	64947	TX

General Provider Information

NPI Number	:	1235416033
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAMES G. JOHNSON JAMES JOHNSON

Provider Business Mailing Address
First Line	:	4422 87TH ST
Second Line	:
City	:	LUBBOCK
State	:	TX
Zip	:	79424-4232
Country	:	US
Telephone Number	:	512-944-7876
Fax Number	:

Provider Business Practice Location Address
First Line	:	1311 CHISHOLM TRL STE 301
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78681-2969
Country	:	US
Telephone Number	:	512-944-7876
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2011
Last Update Date	:	02/07/2024

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Directions to “ MR. JAMES G. JOHNSON JAMES JOHNSON” Practice Location

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