Individual
JOHNNY SCOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
523 REBECCA DR, CEDAR HILL, TX 75104-3061
(214) 226-7681
Mailing address
523 REBECCA DR, CEDAR HILL, TX 75104-3061
(214) 226-7681
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
69208
TX
Other
Enumeration date
09/06/2016
Last updated
09/06/2016
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