Individual
MR. MICHAEL HOWARD JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4504 BOAT CLUB RD STE 800, FORT WORTH, TX 76135-7002
(817) 237-0515
Mailing address
9157 STEINER ST, KELLER, TX 76248-6197
(210) 392-6186
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA01163
TX
Other
Enumeration date
07/19/2006
Last updated
07/08/2007
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