Organization
18 AND UNDER MD, PA
Active
Other names
18 & UNDER MD
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE M JOHNSON CPPM (PRACTICE ADMINISTRATOR)
(972) 691-1240
Entity
Organization
Contact information
Practice address
3041 CHURCHILL DR, SUITE 300, FLOWER MOUND, TX 75022-2706
(972) 691-1240
(972) 691-2073
Mailing address
3041 CHURCHILL DR STE 300, FLOWER MOUND, TX 75022-5906
(972) 691-1240
(972) 691-2073
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
L8145
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0072NC
BCBS GRP
TX
Enumeration date
07/02/2007
Last updated
04/06/2026
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