Organization
PEDIAQ
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FREDERICK JOHNSON DO (MEDICAL DIRECTOR)
(214) 984-3900
Entity
Organization
Contact information
Practice address
17101 PRESTON RD, STE 115, DALLAS, TX 75248-1331
(214) 984-3900
(972) 294-3343
Mailing address
17101 PRESTON RD, STE 115, DALLAS, TX 75248-1331
(214) 984-3900
(972) 294-3343
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
—
—
Other
Enumeration date
07/23/2015
Last updated
07/23/2015
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