Individual
DR. RILEY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
209 SAINT LOUIS AVE STE 100, FORT WORTH, TX 76104-1279
(817) 294-0934
(817) 294-1488
Mailing address
209 SAINT LOUIS AVE STE 100, FORT WORTH, TX 76104-1279
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
S5940
TX
208VP0014X
Interventional Pain Medicine Physician
Primary
S5940
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/20/2018
Last updated
06/16/2023
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