MEDICARE: JOHNSON CHIROPRACTIC HEALTH CENTER

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	111N00000X	Chiropractor	DC4677	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1912175753
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHNSON CHIROPRACTIC HEALTH CENTER

Provider Business Mailing Address
First Line	:	1409 WEST MOORE
Second Line	:
City	:	TERRELL
State	:	TX
Zip	:	75160-2303
Country	:	US
Telephone Number	:	972-563-1557
Fax Number	:	972-563-1527

Provider Business Practice Location Address
First Line	:	1409 WEST MOORE
Second Line	:
City	:	TERRELL
State	:	TX
Zip	:	75160-2303
Country	:	US
Telephone Number	:	972-563-1557
Fax Number	:	972-563-1527

Authorized Official
Title or Position	:	OWNER/DOCTOR
Name	:	DR. EULALIA DARLENE JOHNSON
Credential	:	DC
Telephone Number	:	972-563-1557

Provider Enumeration Date	:	02/14/2008
Last Update Date	:	05/14/2008

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Directions to “JOHNSON CHIROPRACTIC HEALTH CENTER ” Practice Location

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