Individual
ANNELLE RAE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
350 N CARTWRIGHT RD, VAN ALSTYNE, TX 75495-7111
(903) 482-9153
(903) 482-9514
Mailing address
350 N CARTWRIGHT RD, VAN ALSTYNE, TX 75495-7111
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
2009017805
MO
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
N8798
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1386670313
—
MO
05
—
200653200A
—
KS
05
—
281322202
—
TX
Enumeration date
06/23/2006
Last updated
09/19/2011
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