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Individual

ROBERT JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
301 UNIVERSITY BLVD, GALVESTON, TX 77555-5302
(409) 772-2222
Mailing address
301 UNIVERSITY BLVD, GALVESTON, TX 77555-5302
(409) 772-2222

Taxonomy

Speciality
Code
Description
License number
State
2083A0100X
Aerospace Medicine Physician
M1803
TX
208600000X
Surgery Physician
Primary
M1803
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
176389801
TX
Enumeration date
12/14/2006
Last updated
05/11/2009
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