Individual
DESIRRAY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
43702 HWY BUSINESS 290, WALLER, TX 77484
(832) 368-0792
Mailing address
P.O. BOX 2266, PRAIRIE VIEW, TX 77446
(832) 368-0792
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/10/2016
Last updated
05/10/2016
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