Organization
CENTRAL PARK CLINIC COORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CARRIE ANN JOHNSON MSN, FNP-C (PRESIDENT)
(254) 732-4139
Entity
Organization
Contact information
Practice address
8020 CENTRAL PARK DR, SUITE 3, WACO, TX 76712-6652
(254) 732-4139
(254) 732-4209
Mailing address
8020 CENTRAL PARK DR, SUITE 3, WACO, TX 76712-6652
(254) 732-4139
(254) 732-4209
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
Other
Enumeration date
06/24/2008
Last updated
06/24/2008
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