Individual
DR. RICHARD LEE JOHNSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS, MD
Contact information
Practice address
82 MEDICAL GROUP/CREDENTIALS, 149 HART STREET, SHEPPARD AFB, TX 76311-3482
(940) 676-2003
Mailing address
5110 CROWN RIDGE DR, WICHITA FALLS, TX 76310-1768
(940) 689-8896
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DS0000005348
TN
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
MD0000035690
TN
Other
Enumeration date
12/16/2005
Last updated
09/11/2025
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