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NPI Code Detail

MEDICARE: JOHNATHAN WALKER

MEDICARE: JOHNATHAN WALKER
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1740062280
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHNATHAN WALKER
Provider Business Mailing Address
First Line : 17110 DARIEN WING
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78247-5835
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 700 N SAINT MARYS ST
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78205-3507
Country : US
Telephone Number : 210-855-3780
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2023
Last Update Date : 10/19/2023

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Directions to “ JOHNATHAN WALKER ” Practice Location

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