Individual
DR. GLEN THOMAS JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6606 LBJ FWY STE 200, DALLAS, TX 75240-6524
(972) 715-5000
Mailing address
PO BOX 650865, DALLAS, TX 75265-0865
(972) 715-5000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
M4218
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200194304
—
TX
01
—
8EQ708
BCBS TX
TX
Enumeration date
08/08/2007
Last updated
10/28/2015
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