Individual
JOHNNY WAYNE PAUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3551 ROGER BROOKE DR, FORT SAM HOUSTON, TX 78234-4504
(210) 916-3400
Mailing address
3551 ROGER BROOKE DR, FORT SAM HOUSTON, TX 78234-4504
(210) 916-3400
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA13246
TX
363A00000X
Physician Assistant
Primary
PA9102371
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1043024
NCCPA BOARD CERTIFICATION
FL
01
—
U3830Z
MEDICARE NUMBER
FL
Enumeration date
10/24/2005
Last updated
02/03/2026
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