Individual
SHARON D JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.,L.D.
Contact information
Practice address
3840 HULEN ST, HTN, CLIENT ACCOUNTING, FORT WORTH, TX 76107-7277
(817) 569-4395
(817) 569-4517
Mailing address
3840 HULEN ST, HTN, CLIENT ACCOUNTING, FORT WORTH, TX 76107-7277
(817) 569-4395
(817) 569-4517
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT00080
TX
133VN1004X
Pediatric Nutrition Registered Dietitian
DT00080
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145907501
—
TX
01
—
8F6285
BCBS
TX
Enumeration date
12/20/2006
Last updated
04/29/2010
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