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NPI Code Detail

MEDICARE: MIKI JOHNSTON

MEDICARE: MIKI JOHNSTON
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
11041C0700XClinical Social Worker58488TX

General Provider Information

NPI Number : 1598269912
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIKI JOHNSTON
Provider Business Mailing Address
First Line : 16980 DALLAS PKWY STE 204
Second Line :
City : DALLAS
State : TX
Zip : 75248-1910
Country : US
Telephone Number : 214-727-5092
Fax Number :
Provider Business Practice Location Address
First Line : 16980 DALLAS PKWY STE 204
Second Line :
City : DALLAS
State : TX
Zip : 75248-1910
Country : US
Telephone Number : 214-727-5092
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2018
Last Update Date : 06/16/2018

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Directions to “ MIKI JOHNSTON ” Practice Location

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