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NPI Code Detail

MEDICARE: DR. BOBBY JOHNSON JR. DO

MEDICARE: DR. BOBBY JOHNSON JR. DO
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
1207P00000XEmergency Medicine PhysicianL8749TX

General Provider Information

NPI Number : 1336253590
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BOBBY JOHNSON JR. DO
Provider Business Mailing Address
First Line : 301 PRAIRIE OAK CT
Second Line :
City : BURLESON
State : TX
Zip : 76028-2281
Country : US
Telephone Number : 817-707-4235
Fax Number :
Provider Business Practice Location Address
First Line : 230 DEER RIDGE DR
Second Line :
City : ROUND ROCK
State : TX
Zip : 78681-5515
Country : US
Telephone Number : 512-766-1400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2006
Last Update Date : 06/05/2026

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