Individual
JOHNATHAN G. NEWBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5201 HARRY HINES BLVD, MEDICAL STAFF SERVICES, DALLAS, TX 75235-7708
(214) 590-8006
Mailing address
PO BOX 660599, DALLAS, TX 75266-0599
(214) 590-4105
(214) 590-4162
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA02318
TX
Other
Enumeration date
02/23/2006
Last updated
07/08/2007
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