Individual
GLOVER O.L. JOHNSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
E2031
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10019729
AMERIGROUP
TX
05
—
131117704
—
TX
05
—
131117707
—
TX
01
—
1565261
LOUSIANA MEDICAID
TX
01
—
183097000
TEXAS WORKER'S COMP
TX
01
—
4010529
AETNA
TX
01
—
609573
UNITED HEALTHCARE
TX
01
—
8H9486
BCBS
TX
01
—
N504748
WELLCARE
TX
Enumeration date
02/27/2006
Last updated
12/03/2015
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