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Individual

FREDERICK C JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
L4474
TX
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
L4474
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
164307403
TX
05
164307404
TX
05
164307406
TX
05
23981741
NM
01
8S2689
BCBS
TX
Enumeration date
07/13/2006
Last updated
08/27/2013
Update your record

If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.

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