Individual
BLAKE ALAN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
301 UNIVERSITY BLVD, GALVESTON, TX 77555-5302
(409) 747-5727
(409) 747-5715
Mailing address
301 UNIVERSITY BLVD, GALVESTON, TX 77555-5302
(409) 747-5727
(409) 747-5715
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
BP10074436
TX
Other
Enumeration date
06/03/2021
Last updated
06/03/2021
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