Individual
ROBERT ORY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3615 19TH ST, LUBBOCK, TX 79410-1203
(806) 725-2233
(806) 725-0053
Mailing address
2215 NASHVILLE AVE, LUBBOCK, TX 79410-1105
(806) 725-5844
(806) 723-6532
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
LL38314
SC
207P00000X
Emergency Medicine Physician
Primary
R6802
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01222741
—
NM
01
—
678769
MEDICARE
TX
01
—
8JP624
BCBS
TX
Enumeration date
06/08/2015
Last updated
08/31/2018
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