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Individual

MS. BEVERLY LOUISE JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
176 LEGACY TRCE, LA VERNIA, TX 78121-5688
(210) 887-0416
(830) 947-3763
Mailing address
176 LEGACY TRCE, LA VERNIA, TX 78121-5688
(210) 887-0416
(830) 947-3763

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2024060001
TX

Other

Enumeration date
10/10/2024
Last updated
10/10/2024
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