Individual
BRYAN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RD
Contact information
Practice address
771 E SOUTHLAKE BLVD STE 106, SOUTHLAKE, TX 76092-6354
(469) 372-2022
(833) 290-5413
Mailing address
17060 DALLAS PKWY STE 112, DALLAS, TX 75248-1905
(469) 372-2022
(833) 290-5413
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT91917
TX
Other
Enumeration date
02/14/2025
Last updated
02/14/2025
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