Individual
JOHNSON N MWANGI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1720 S BECKHAM AVE STE 102, TYLER, TX 75701-4437
(903) 618-2125
Mailing address
5310 HARVEST HILL RD STE 290, DALLAS, TX 75230-5826
(214) 420-0650
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA011035
TX
363AM0700X
Medical Physician Assistant
PA011035
TX
Other
Enumeration date
01/09/2008
Last updated
02/03/2023
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