Individual
MR. MATTHEW DOUGLAS JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1600 WALLACE BLVD, AMARILLO, TX 79106-1799
(480) 734-4833
Mailing address
301 PARTRIDGE DR, AMARILLO, TX 79124-1415
(480) 734-4833
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
776455
TX
Other
Enumeration date
10/23/2009
Last updated
12/29/2013
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